What is robotically-assisted heart surgery?
Robotically-assisted heart surgery, also called closed-chest heart surgery, is a type of minimally invasive heart surgery performed by a cardiac surgeon. The surgeon uses a specially-designed computer console to control surgical instruments on thin robotic arms.
Robotically-assisted surgery has changed the way certain heart operations are being performed. This technology allows surgeons to perform certain types of complex heart surgeries with smaller incisions and precise motion control, offering patients improved outcomes.
Types of robotically assisted heart surgeries:
- Mitral valve repair
- Septal myectomy
- Tricuspid valve repair (with mitral valve repair)
- Atrial septal defect (ASD) repair
- Patent foramen ovale (PFO) repair
- Removal of cardiac tumors (Myxoma, Fibroelastoma of the mitral or tricuspid valve)
Who is a candidate for robotically assisted heart surgery?
Diagnostic tests are performed to determine if you are an appropriate candidate for robotically-assisted surgery, including a cardiac catheterization and chest x-ray. An echocardiogram and/or a computed tomography scan also may be required to provide more information about your medical condition.
Your surgeon will review the results of these diagnostic tests to determine if you are an appropriate candidate for robotically-assisted surgery. The type of treatment recommended for your condition will depend on several factors, including the type and severity of heart disease, your age, medical history and lifestyle.
Robotic Surgical System
Cleveland Clinic uses a state-of-the-art robotic surgical system that has been approved by the FDA for use in performing many surgical procedures.
The computer-enhanced robotic system consists of three components, including:
- A three-dimensional view of the surgical field, including depth of field, magnification and high resolution
- Instruments on thin robotic arms that are designed to mimic the movement of the human hands, wrists and fingers, allowing an extensive range of motion and more precision
- Master controls that allow the surgeon to manipulate the instruments, translating the surgeon’s natural hand and wrist movements into corresponding, precise and scaled movements
How is robotically-assisted heart surgery performed?
First, three small incisions or “ports” are made in the spaces between the ribs.
The surgical instruments (attached to the robotic arms), and one camera are placed through these ports.
Motion sensors are attached to the robotic “wrist” so the surgeon can control the movement of the surgical instruments.
The surgeon sits at a computer console and looks through two lenses (one for each eye) that display images from the specialized camera with two optical outputs.
From the two optical outputs, the computer generates a clear, three-dimensional image of the surgical site for the surgeon to view.
Foot pedals provide precise camera control, so the surgeon can instantly zoom in and out to change the surgical view.
The surgeon’s hands control the movement and placement of the endoscopic instruments. The robotic “arm and wrist” movements mimic those of the surgeon, yet are possibly more precise than the surgeon’s natural hand and wrist movements.
The surgeon is always in control during the surgery; there is no chance that the robotic arms will move on their own.
The robotically-assisted heart surgery incision: smaller incisions
Traditional open heart surgery incision
Robotically assisted heart surgery incision
Risks / Benefits
What are the risks of surgery?
As with any surgery, there are risks involved. Your surgical risks are related to your age, the presence of other medical conditions and the number of procedures you undergo during a single operation. Your doctor will discuss your personal risks before surgery; please ask questions to make sure you understand all of the potential risks.
What are the benefits of robotically-assisted heart surgery?
Compared with traditional surgery, the benefits of robotically-assisted surgery may include:
- Smaller incisions with minimal scarring
- Less trauma to the patient, including less pain
- Shorter hospital stay (usually 3 to 4 days)
- Decreased use of pain medications
- Less bleeding
- Decreased risk of infection
- Shorter recovery and quicker return to daily and professional activities: The patient can resume normal activities and work as soon as he or she feels up to it; there are no specific activity restrictions after robotically-assisted surgery
Recovery and Outlook
Recovery after robotically-assisted heart surgery
Your doctor will provide specific guidelines for your recovery and return to work, including specific instructions on activity and how to care for your incisions and general health after the surgery.
Most patients can resume normal activities, drive and return to work as soon as they feel up to it -- usually within a few days to one week after surgery.
To maintain your cardiovascular health after surgery, making lifestyle changes and taking medications as prescribed are strongly recommended. Lifestyle changes include:
- Quitting smoking
- Treating high cholesterol
- Managing high blood pressure and diabetes
- Exercising regularly
- Maintaining a healthy weight
- Eating a heart-healthy diet
- Participating in a cardiac rehabilitation program, as recommended
- Following up with your doctor for regular visits
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