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Robotic Cardiac Surgery

What is robotic cardiac surgery?

Robotic cardiac surgery is a form of heart surgery done through very small incisions in the chest. With the use of tiny instruments and robotic devices, surgeons are able to do several types of heart surgery in a way that is much less invasive than other types of heart surgery. The procedure is sometimes called da Vinci surgery because that is the name of the manufacturer of the robot often used for this procedure.

Robotic surgeries have been used for a number of different heart-related procedures, including valve surgery, coronary artery bypass, cardiac tissue ablation, heart defect repair, and tumor removal.

Why might I need robotic cardiac surgery?

The main advantage of robotic cardiac surgery is that the procedure is minimally invasive compared with other forms of heart surgery. Smaller incisions mean that you can heal faster and return to activities more quickly.

Your healthcare provider may recommend robotic cardiac surgery if you need an artery bypass procedure to improve blood flow to the heart and reduce chest pain. Robotic cardiac surgery may also be used to:

Repair or replace stiff or leaky heart valves to improve their function
Correct atrial fibrillation, a common type of arrhythmia

Remove a tumor in the heart
Treat congenital heart conditions

Your healthcare provider may have other reasons to recommend robotic cardiac surgery.

What are the risks of robotic cardiac surgery?

One of the main advantages of robotic cardiac surgery is that it minimizes many of the risks related to major heart surgery. The surgeon does not have to cut through the breastbone to open your chest, so many of the complications involved with such a major surgery are eliminated.

Robotic cardiac surgery still requires anesthesia before the procedure and, as with any kind of surgery, there are always risks involved, including:

Heart attack
Stroke
Infection
Death

You may have other risks, based on your specific medical condition. Be sure to talk with your healthcare provider about any concerns you have before your procedure.

How do I get ready for robotic cardiac surgery?

As with any surgical procedure, your healthcare provider will do a full assessment of factors including your age, medical history, and lifestyle, as well as the overall severity of the disease, will determine whether you are a good candidate for the procedure.

Your healthcare provider will explain the procedure to you and ask you if you have any questions.
You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.
In addition to a complete medical history, your healthcare provider(s) may perform a physical exam to ensure you are in good health before you undergo the procedure. You may also undergo blood tests and other diagnostic tests.
Your healthcare provider(s) may recommend taking an aspirin prior to the procedure.
If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider(s).
Tell your healthcare provider(s) if you are sensitive to or are allergic to any medications, latex, iodine, tape, contrast dyes, and anesthetic agents (local or general).
Tell your healthcare provider(s) of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
Tell your healthcare provider(s) if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
Tell your healthcare provider(s) if you have a pacemaker.
If you smoke, you should stop smoking as soon as possible prior to the procedure, in order to improve your chances for a successful recovery from surgery and to improve your overall health status.
You will be asked to fast for 8 hours before the procedure, generally stopping eating, drinking, or any oral medicines after midnight

Based on your medical condition, your healthcare provider(s) may request other specific preparation.

What happens during robotic cardiac surgery?

The following is the general sequence of events that will most likely occur during robotic cardiac surgery:

You may receive a sedative prior to the procedure to help you relax.
You will be placed under general anesthesia for the surgical procedure and a breathing tube will be placed.
A surgeon will make a series of keyhole-sized incisions on the side of your chest. These incisions will align with the openings between your ribs.

Depending on the procedure being done, several precision-guided robotic arms will be inserted into these incisions.
These robotic arms hold and manipulate tiny instruments in order to perform the required tasks on the heart or surrounding arteries.
A tiny video camera will be inserted into another incision to provide a magnified, three-dimensional image of the operating site.
The surgeon will control the robotic arms and camera from a special console located within the operating room.
On completion of surgery, the surgeon will remove the instruments and close the incisions.

Talk with your healthcare provider about what you will experience during your (procedure or test).

What happens after robotic cardiac surgery?

Once the robotic cardiac surgery is complete, you will be moved to the recovery area to be monitored. You can expect a relatively short hospital stay to follow, usually half as long as that following conventional open heart surgery. Your healthcare provider will typically discharge you once your pain is under control, you can retain liquids without nausea and vomiting, and your lab tests appear near normal or your baseline prior to the procedure.

The less invasive nature of robotic cardiac surgery also means that you can expect less scarring on your chest. Conventional heart surgery may leave a 10-inch scar on your chest. Robotic cardiac surgery just leaves a handful of smaller scars on the side of your chest.

Your healthcare provider may give you other instructions about what you should do after your procedure. Here is a typical list.

After being discharged from the hospital, most people can manage their pain with over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Postsurgical pain also tends to go away much faster than with traditional procedures.

Keep your incisions clean and dry. Do not use powders, lotions, or ointments on the incision lines as this can be irritating to the skin and cause prolonged healing and increase the risk for infection. No soaking the incisions in water until it is approved by your healthcare provider.

You should plan to have someone give you a ride home from the hospital.

You may also return to normal activities more quickly than you would after a conventional heart surgery. Most people can resume their normal activities after three weeks. Specific recommendations for activity will be provided by your healthcare provider.

Ask your healthcare provider what types of foods that should eat and what types of foods to avoid once you are at home. The recommended diet will depend on all of your healthcare needs.

Your healthcare provider will typically schedule follow-up appointments after the procedure to check your progress. Be sure to notify your health care provider immediately if any symptoms occur after the procedure, such as chest pain or discomfort. Complications are rare after robotic heart surgery, but possible, so it is important to carefully monitor for any symptoms and report them to your health care provider.

Remember to take all or your medications as prescribed.