You Want To Operate on My Heart with a Robot?

When you hear about robotic surgery, you may envision a scene from a science fiction movie, where a walking, talking robot does all the work. The truth is more complicated.

A robot serves as a high-end assistant for your surgeon. The robot helps your surgeon better visualize what’s happening inside your body and achieve results that are often better than with traditional surgical approaches.

Traditional surgeries require a substantial cut in your chest to provide access to your heart. But robot-assisted procedures require only small incisions around the surgery site. The robot’s arms and tiny camera are inserted through these holes.

Once inside your body, the arms and instruments are controlled by the surgeon, who sits at a console that might look at home on a video game. Using high-quality video provided by the camera, your surgeon controls the instruments on the robot’s arms.

When Is a Robot Used?

The idea of using robots for surgery has been around for more than five decades, starting with a U.S. military quest to provide better care for injured soldiers in battlefields. Today, robots are used for a wide range of surgeries, including cardiac procedures.

The first robotic surgery on the heart was a mitral valve repair in 1998. But it’s only been in the last decade or so that these surgeries have become more common.

Today, robot assistance is most commonly used for repairing or replacing the mitral valve (located between your upper left and lower left heart chambers) or repairing the tricuspid valve (it controls the flow of blood from your body into your heart).

As the techniques and technology are further refined, it’s likely there will be increased usage of robots for other types of heart surgery, including the coronary bypass, which is used to improve blood flow to your heart by working around critical arteries that have become narrowed or blocked.

Is a Robotic Procedure for You?

Far from replacing your surgeon, the robot simply provides a better surgical experience. Among the advantages:

• Smaller incisions (versus an open chest surgery) make for a minimally invasive procedure. This means less bleeding, a shorter hospital stay and a quicker recovery time. The difference in healing time can be substantial: as little as a week or two, instead of two months if your sternum has to be opened.
• The robot’s high-quality camera enhances the surgeon’s ability to see and perform the procedure. For example, your surgeon can zoom in for a much closer view, using the 3D image of the surgical area.
• The connection between the console and the robot’s instruments allows your surgeon to make incredibly fine movements that mimic the way human hands move, but with more precision.
• There is also less pain, fewer complications and a decreased need for pain medications.

There are no disadvantages unique to robot-assisted procedures. All minimally invasive procedures carry some risk, which your doctor will explain to you. Similarly, there are always risks with heart-related surgeries, regardless of the approach.

Still, robot-assisted surgeries are not ideal for everyone. Your team will make sure that it can be done safely before suggesting this approach. And it’s important that you achieve the same results that you would through a traditional procedure.

Among the most important factors is whether you can safely be put on a heart-lung machine. And obstructions around the heart (scarring around the lungs, for example), could make it difficult to get the robotic arms into position.

There’s also not as much value in the approach if you need other work (a coronary bypass, for example) that can’t be done with a robot-assisted procedure. If you need a multi-step operation, it will likely be done with a traditional open approach.