How Robotic Heart Surgery Can Speed Recovery

Heart surgeries are increasingly being performed with robotic technology. This can mean smaller incisions, fewer complications and faster recovery times for patients. Compared with traditional open-heart surgery, robotic cardiac procedures typically allow patients to get back to their normal activities sooner.

“For example, if a patient had open-heart surgery, and they want to get back to playing golf, they may need to wait two to three months before they can play comfortably,” says Yasir Abu-Omar, MD, PhD, Chief of Cardiac Surgery and Co-President of University Hospitals Harrington Heart & Vascular Institute. “If done with a minimally invasive approach with robotic assistance, the same patient can get back to playing golf in a week or two.”

What Is Robotic Heart Surgery?

Robotic heart surgery is a type of minimally invasive surgery that is performed on the heart with the assistance of a robot. The robot is controlled by a surgeon who specializes in robotic procedures.

“It’s important for patients to understand that the robot is not working independently of the surgeon,” says Dr. Abu-Omar. “It’s a tool that enhances what we can do. It improves visualization and magnification and provides outstanding dexterity. The main advantage is that it allows us to achieve the same objectives and benefits of traditional open-heart surgery but with a far less invasive approach.”

How It Works

The surgeon uses a console to control robotic arms equipped with tiny surgical instruments and a high-definition 3D camera. This allows the surgeon to maneuver the robotic arms into the chest through small incisions between the ribs.

“It is akin to using a joystick in a video game, where the hand movements are replicated by the robot,” says Dr. Abu-Omar. “Unlike most open-heart operations, this avoids division of the sternum – the central chest bone. We are able to make a series of small port incisions, or in some cases, a small incision between the ribs called a mini-thoracotomy.”

Benefits of Robotics for Heart Surgery

Robotic cardiac surgery may take a little longer than open-heart surgery, but the recovery time for patients tends to be notably shorter. Benefits of robotic heart surgery often include:

• Small incisions that minimize tissue damage and heal faster.
• Minimal scarring and better appearance.
• Less pain during recovery.
• Lower risk of complications, such as infections or bleeding.
• Shorter hospital stay.

Some robotic heart surgeries can be performed without a heart-lung machine, which may help reduce the risk of stroke and certain neurological complications.

What Heart Conditions Can Be Treated?

The number of heart conditions that can be treated with robotic heart surgery is growing. The three most common robot-assisted heart surgeries are:

• Mitral valve repair surgery
• Coronary artery bypass graft surgery (CABG)
• Atrial fibrillation (AFib) mini-maze surgery

“These three make up about 90 to 95% of the robotic heart procedures we do,” says Dr. Abu-Omar. “We perform robotic heart procedures almost daily and are adding new surgeries all the time.”

The population of patients suitable for robotic surgery continues to expand as the technology improves. But to be a good candidate for robotic heart surgery, you need to be a suitable candidate for surgery in the first place. You should be stable enough for elective surgery and have a favorable chest anatomy.

You may not be a good candidate for robotic heart surgery if you have:

• Had previous open-heart surgery, although it is possible in select patients.
• Morbid obesity.
• Severe disease affecting the aorta and great vessels.

Your doctor will do diagnostic tests to help determine whether robotic heart surgery may be right for you.

What Are the Risks?

The risks are essentially the same as the risks for open-heart procedures when performed by an expert team. Risks include:

• Heart attack
• Stroke
• Loss of blood
• Anesthesia-related complications
• Arrhythmia (irregular heartbeat)
• Infection
• Death

There is always a small chance that robotic surgery needs to be converted into an open procedure in cases with unexpected findings or complications.

A Growing Choice

Dr. Abu-Omar says the number of robotic heart surgeries performed every year is only going to increase. As more surgeons are trained and new techniques become available, robot-assisted surgeries will be recommended to more patients.

“It is becoming the mainstream way of performing surgery in many specialties, from urology and gynecology to thoracic surgery,” he says.

Hybrid treatments that combine transcatheter and robotic approaches are becoming increasingly common, too. For example, patients can have a combination of stents and bypass in one procedure, which can reduce invasiveness and maximize rapid recovery.

Related Links

The cardiac surgeons at University Hospitals Harrington Heart & Vascular Institute use the da Vinci Robotic Surgical System to perform robotic coronary artery bypasses and other heart surgeries with remarkable outcomes.