Robot-Assisted Cardiac Procedures
Definition
A robot-assisted cardiac surgery is when a doctor guides small robotic arms through tiny incisions to do surgery on the heart. It allows for greater range of motion than regular surgery.
Reasons for Procedure
This method is used when surgery needs to be precise. Examples of robot-assisted cardiac surgeries are:
- Mitral valve repair
to treat:
- Stenosis —narrowing of the mitral valve
- Regurgitation—leakage of the mitral valve
- Coronary artery bypass grafting
(CABG) to treat:
- Blockages in the heart’s arteries
- Severe chest pain, such as angina that has not been helped by medicine
- Atrial septal defect repair may be done to treat a hole between the upper chambers of the heart that does not close properly during fetal development
- Biventricular pacemaker lead placement may be done to treat heart failure due to atrial fibrillation, which is an irregular heart rhythm in the upper chambers of the heart
Pacemaker leads implanted in heart to maintain normal rhythm.
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The benefits of this type of surgery are:
- Less blood loss
- Lower risk of infection
- Less scarring
- Less trauma to the body
- Faster recovery
- Less time in the hospital
Possible Complications
Problems from robotic-assisted surgeries are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Damage to nearby organs or structures
- The need to switch to traditional surgery types, such as traditional laparoscopic or open surgery
Things that may raise the risk of problems are:
- Smoking
- Chronic diseases, such as diabetes or obesity
- Alcohol use disorder
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging tests
Anesthesia
You may be given:
- Local anesthesia—the area will be numbed
- General anesthesia —you will be asleep
Description of the Procedure
Several small incisions will be made in the spaces between the ribs. A needle may be used to inject gas into the area. This will make it easier to see inside the body. A scope with a small camera on the end will be passed through one of the incisions. The camera will display the area on a video screen. Next, robotic arms holding tools will be inserted through the holes.
While sitting nearby, the doctor will use lenses to look at a magnified 3-D image of the inside of the body. Another doctor will adjust the camera and tools. The robotic arms and tools will be guided by the surgeon. When the surgery is done, the tools will be removed. Stitches or staples will be used to close the incisions. Bandages will be used to cover them.
How Long Will It Take?
About 1 to 4 hours. It depends on the type of surgery.
Will It Hurt?
It depends on the surgery, but pain and swelling are common in the first 2 weeks. Medicine and home care can help.
Average Hospital Stay
How long you will stay in the hospital depends on the surgery that was done.
Post-procedure Care
At the Care Center
Right after the procedure, the staff may give you medicine to treat pain.
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
You can also lower your chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work. It will take about 3 to 6 weeks to heal.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision
- Cough, shortness of breath, or chest pain
- Rapid weight gain
- Pain or swelling in your feet, calves, or legs
- Headache or lightheadedness
- New or unexpected symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Heart Association
https://www.heart.org
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
Heart and Stroke Foundation of Canada
https://www.heartandstroke.ca
REFERENCES:
Approaches to heart surgery. Columbia University Medical Center, Department of Surgery website. Available at: https://columbiasurgery.org/heart/approaches-heart-surgery. Accessed August 17, 2020.
Robotic surgery. The Robotic Surgery Center at NYU Langone Medical Center website. Available at: http://robotic-surgery.med.nyu.edu/for-patients/what-robotic-surgery. Accessed August 14, 2020.
Robotically assisted heart surgery. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17438-robotically-assisted-heart-surgery. Accessed August 17, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 8/17/2020