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Robotic Heart Surgery

Robotic surgery is a type of minimally (hybrid) invasive heart surgery. This surgery is robotically assisted, also known as closed heart surgery performed by cardiac surgeon. Robotic surgery is done through very small cuts in the chest with the use of specially designed computer console to control tiny surgical instruments/tools delicately and precisely on thin robotic arms. Robotic heart surgery technology allows surgeons to perform certain types of complex heart related procedures including valve surgery, coronary artery bypass, cardiac tissue ablation, heart defect repair and removal of tumor with smaller incisions and precise motion control to give improved outcomes and faster recovery.

In most of the cases, the endoscopic robotic approach may allow patients to return to normal routine faster than with sternotom. For example totally endoscopic robotic mitral valve repair. The robotic surgery proves useful for this problem as it allows for perfect visualization for mitral valve repair. Robotic instruments have the same ability and motion of a surgeon’s hands but are much smaller without tremors in surgeon’s hand; these types of unwanted movements are eliminated by the use of the robotic system. A highly trained and experienced surgeon and equally experienced team are required for robotic surgery. The surgeon sits at a console in the operating room controls the instruments while looking at a high-definition image from the camera inside the patient and controls the robot to perform the surgery properly.

There are certain types of heart surgeries that can be performed robotically such as:

1. Mitral valve repair/replacement

2. Maze treatment for atrial fibrillation

3. Atrial septal defect (ASD) closure

4. Atrial myxoma

5. Tricuspid valve repair/replacement

6. Septal myectomy for obstruction hypertrophic cardiomyopathy (HOCM)

7. Coronary artery bypass

8. Pacemaker wire placement

In robotically assisted surgery, patient will be given sedative and general anesthesia to help them relax before the procedure and will place a breathing tube in the mouth. Then the surgeon will make small keyhole sized incisions/cuts near the chest in alignment with the openings between the ribs. Patient may need to be placed the heart-lung machine for this surgery. Surgeon will insert several precision-guided robotic arms to into these incisions to do the required task on the heart or surrounding arteries depending on the treatment. A small camera will be inserted into another incision to provide a magnified, three-dimensional image of the operating area. The robotic arms and camera will be controlled by a surgeon from a console located within the operating room. Surgeon will then remove the instruments and close the incisions after the completion of the surgery.

Post surgery patient will be shifted to the recovery area to be monitored by the doctors. Patient will be discharge after a short stay once the pain is under control. Robotic cardiac surgery just leaves a few smaller scars on the side of your chest whereas; the open-heart surgery may leave a 10-inch scar on your chest. Patient needs to keep the incisions clean and dry, advised not to use powders, lotions, or ointments on the incision lines as this can irritate the skin and cause prolonged healing and increase the risk for infection. Patient needs to fix follow up visits to the doctor to check on their recovery progress and should contact immediately if he or she may feel any chest pain or discomfort.

Robotic cardiac surgery has lower risk than open heart surgeries as surgeon do not have to cut through the breastbone to open the chest which removes many complications involves in the open heart surgery. But robotic surgery still requires anesthesia and may have some risk involved like heart attack, stroke, infection or death based on specific medical condition of the patient.

There are more benefits in robotically assisted surgery when compared to traditional heart surgery methods that includes:

1. Small incisions/cuts with less scarring

2. Less pain and trauma to the patient

3. Shorter hospital stay

4. Less pain medications required

5. Reduced bleeding

6. Less risk of infection

7. Faster recovery and patient can go back to normal routine as soon as they feel.

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