|
What is robotic heart surgery?
Robotic heart surgery is a type of minimally invasive surgery performed
using robotic arms. The surgeon operates the robotic arms using joystick-like
devices attached to a computer console located in the operating room. The use of
robotic technology enables surgeons to offer their patients a safe, less
invasive option for certain heart procedures.
How is the surgery done?
Instead of making an incision down the sternum (breastbone) and cutting
through bone and muscle, the surgeon performing robotic surgery makes three
small holes--called keyhole incisions or ports--in the spaces between the
patient's ribs. Three robotic arms--two holding surgical instruments and one
holding a tiny, high-tech camera--are inserted into the patient through these
ports.
The camera projects three-dimensional images from inside the patient's chest
onto a monitor at the computer console. Motion sensors attached to the robotic
arms allow the surgeon to manipulate the surgical instruments. The robotic arms
precisely mimic the movements of the surgeon's arms and wrists. The robotic arms
are capable of making small, steady movements, allowing for extreme precision in
the tiny operating field. The surgeon remains in total control throughout the
procedure. There is no chance that the robotic arms will move on their own.
When is heart surgery necessary?
Surgery may be necessary for patients with a diagnosis of coronary artery
disease. This means one or more coronary arteries (the blood vessels feeding the
heart muscle) is blocked, starving the heart of the oxygen and nutrients it
needs to survive.
Some patients with coronary artery disease may be successfully treated with
medications; others may undergo procedures such as angioplasty or stenting. When
these treatments are not effective or are not appropriate for a patient, the
surgeon may need to "bypass" the blockage to improve blood flow and
prevent damage to the heart muscle.
At this time, robot-assisted heart surgery is performed on patients who have
only one or two blocked arteries that needs to be bypassed. The surgery is most
often used for patients who have a blocked left anterior descending (LAD) artery
that can be bypassed using the left internal mammary artery (LIMA). Patients
requiring more than two bypasses are currently not candidates for this surgical
technique.
What are the benefits of robotic heart surgery?
For the right patients, robotic surgery--like other types of minimally
invasive surgery--often results in shorter hospitals stays and quicker recovery.
Other possible benefits of robotic surgery include:
- Decreased trauma (damage) to the tissues of the chest wall, including
bone, muscles and blood vessels
- Less pain and a decreased need for pain medication
- Less bleeding
- Less scarring
- Less chance of wound infection
- Improved patient comfort
- Quicker return to daily activities
Robot-assisted bypass surgery also allows the surgeon to operate in a closed
chest, beating heart environment. This eliminates the need for placing the
patient on a heart-lung bypass machine, which circulates oxygenated blood during
surgery.
Are there other uses for robotic technology in heart surgery?
Robotic technology also is being used to harvest blood vessels to use as
grafts to bypass blocked coronary arteries. This type of robotic technology
functions as the surgeon's "third arm" and operates under voice
guidance.
What does the future hold?
In the future, robotic surgery may allow the surgeon to perform total
endoscopic (through scopes) coronary artery bypass (TECAB) procedures. This will
allow the surgeon to perform multiple bypasses without having to open the
patient's chest. Robotic surgery also may become an option for patients needing
other types of heart procedures, such as mitral valve replacement and treatment
for heartbeat irregularities.
|
