By Sebastian Pagni, M.D.
As breakthroughs in minimally invasive surgery continue, I am pleased that we are now able to give many patients the option of having robotically-assisted surgery for common cardiothoracic conditions such as heart valve disorders, arrhythmias and coronary heart disease.
At Jewish Hospital, the da Vinci® Surgical System for minimally invasive surgical procedures is also used for urology, gynecology and bariatric surgeries. da Vinci heart procedures are the most recent to develop because of the complex nature of these surgeries. Jewish Hospital is the only hospital in the metro Louisville region performing minimally invasive heart procedures.
The da Vinci is a robotically-assisted surgical system that uses small incisions to introduce miniaturized instruments and a high-definition camera, enabling surgeons to view magnified, high-resolution images of the surgical site. At the same time, robotic and computer technologies translate the surgeon’s hand movements into precise micro-movements of the da Vinci instruments, required to repair intra-cardiac structures.
The da Vinci instruments are more flexible and operate much more like the human hand than previous minimally-invasive surgical systems. It allows us to perform incredibly precise surgical procedures, such as mitral and tricuspid leaking valves, using small incisions.
da Vinci surgery is an effective, least invasive treatment option for some cardiothoracic procedures and there are many potential benefits for the patient including:
- Reduced risk of infection
- Less blood loss and need for blood transfusions
- Shorter hospital stay
- Less pain and scarring
- Faster recovery and return to normal activities
- Greater cosmetic and patient satisfaction
Traditional “open heart” surgery usually involves an 8-10-inch incision, splitting the patient’s breastbone and spreading the ribs with a retractor. Recovery after the surgery is longer and often painful due to healing of the large chest wound. Patients are usually not allowed to drive for several weeks and must avoid heavy lifting for three months following an open-heart surgery.
With da Vinci’s minimally invasive techniques, small incisions can be made between the ribs to perform valve repairs to the heart or removal of cardiac masses and closing “holes” by using thoracoscopy – the insertion of a miniaturized video camera between the ribs.
Patients undergoing da Vinci robotic heart surgery usually have just three tiny instrument incisions less than one centimeter in size and a small working port incision (3cm). In most cases, patients have far fewer restrictions on activities, and are up and active much sooner. Using this robotic approach, recovery typically requires a 3-4 day stay in the hospital and a return to normal activity in about two weeks. In an open heart surgery, the recovery is about 6-8 weeks. For patients who qualify, this innovative new approach is certainly a welcome option.
In addition, some studies have indicated that minimally invasive surgery can help increase survival after surgery, which allows treatment parameters to include patients who may not normally be considered candidates for surgery because they were not strong enough to undergo a traditional open-heart procedure.
For more information about da Vinci cardiothoracic surgery at Jewish Hospital, visit www.jhsmh.org or call 502-583-8383.
Image from: www.biomed.brown.edu
Sebastian Pagni, M.D. is a Cardiothoracic Surgeon, University Cardiothoracic Surgical Associates/Jewish Hospital/University of Louisville.