Robotic Cardiothoracic Surgery

When medication- and catheter-based treatments cannot relieve symptoms, surgery remains the accepted treatment for a range of cardiothoracic conditions, including but not limited to: mitral valve prolapse, atrial septal defect and coronary artery disease.

Facing either traditional cardiac surgery or open surgery to treat disorders of the organs and tissues in the chest cavity can be a frightening experience. While it may be difficult to focus on next steps, in fact, you may have several choices to make, including which hospital and which surgeon to go to, and which procedure to choose. Learning as much as possible about your surgical options, including minimally invasive alternatives to traditional open surgery may ease some of your concerns.

Potential Robotic Surgery Benefits

While surgery is generally the most effective way to treat disorders of the heart, lungs and esophagus, traditional open surgery has a number of inherent drawbacks caused primarily by making a large incision, splitting of the breastbone and spreading the ribs to access the thoracic space. In addition to an 8- to 10-inch scar down the center of your chest, splitting of the breastbone leads to a lengthy recovery time of eight to twelve weeks, as well as a prolonged delay before you will return to normal daily activities.

Fortunately, less invasive options are increasingly available for patients facing cardiothoracic surgery. Many cardiothoracic surgeons are recognizing the benefits of smaller incisions made between the ribs to perform coronary bypass or make repairs to the heart or esophagus under visualization using thoracoscopy – the insertion of a miniaturized video camera between the ribs. But this approach has limitations and is not well suited to more complex cardiac procedures.

Enter the da Vinci^® Surgical System, providing surgeons and patients with what may be the most effective, least invasive treatment alternative for even the most complex cardiothoracic procedures such as mitral valve repair. Among the benefits of da Vinci cardiothoracic surgery are a reduced risk of infection, less blood loss and need for blood transfusions, shorter hospital stay, less pain and scarring, faster recovery and a quicker return to normal activities. Additionally, surgery with the da Vinci Surgical System offers the potential for a better clinical outcome.

da Vinci Surgical System

The da Vinci Surgical System is powered by state-of-the-art robotic technology. The system allows your surgeon’s hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative site. The magnified, three-dimensional view the surgeon experiences enables him to perform precise surgery in complex procedures through small surgical incisions.

The da Vinci System enhances surgical capabilities by enabling the performance of complex surgeries through tiny surgical openings. The System cannot be programmed nor can it make decisions on its own. The da Vinci^® System requires that every surgical mauveuver be performed with direct input from your surgeon.

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Resources 

Rodgers, E. Heart valve repair or replacement for mitral valve regurgitation or prolapse. WebMD. March 10, 2005  Bach DS. Choice of prosthetic heart valves:update for the next generation. J Am Coll Cardiol. 2003 Nov 19;42(10):1717-9.

Ruel M, Kulik A, Rubens FD, Bedard P, Masters RG, Pipe AL, Mesana TG.  Late incidence and determinants of reoperation in patients with prosthetic heart valves. Eur J Cardiothorac Surg. 2004 Mar;25(3):364-70.

Thourani VH, Weintraub WS, Guyton RA, et al.  Outcomes and Long-Term Survival for Patients Undergoing Mitral Valve Repair Versus Replacement.  Circulation. 2003;108:298-304 (Emory University Atlanta)

Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL: Valve repair improves the outcome of surgery for mitral regurgitation: a long-term study. Circulation. 1995; 91:1022-8

Gillinov AM, Wierup PN, Blackstone EH, et al. Is Repair Preferable to Replacement for Ischemic Mitral Regurgitation? J Thorac Cardiovasc Surg 2001 Dec; 122(6):1125-41 (Cleveland Clinic)

Grossi E, Goldberg J, LaPietra A, et al.  Ischemic mitral valve reconstruction and replacement:  Comparison of long term survival and complications.  J Thorac Cardiovasc Surg 2001 Dec; 122(6):1107-24 (NYU)

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.