Robotic Heart Surgery in Delhi, India

Robotic heart surgery is a new age of surgical precision. Heart surgeries have traditionally been open surgeries, which involve opening the chest to access the heart, which can lead to prolonged recovery, pain, blood loss and chances of infections. Robotic heart surgery, on the other hand, makes use of small incisions through which a tiny camera and surgical equipment can be passed to conduct surgery.

Benefits of Robotic Surgery

The procedure ensures:

• Smaller incisions
• Lesser blood loss and need for transfusions
• Fewer complications
• Minimal scarring
• Quicker recovery
• Lesser pain
• Lesser chances of infection
• Shorter hospital stay
• Decreased mortality

Procedure type

Robotic surgery, minimally invasive surgery

Speciality

Cardiac Surgery

Body Location

Chest, Heart

Why is robotic heart surgery performed?

Robotic cardiac surgery is performed for several reasons. Some of them include:

Minimally Invasive Approach: Robotic heart surgery allows for a minimally invasive approach compared to traditional open-heart surgery. It involves smaller incisions, which result in less trauma to the chest, reduced blood loss, and decreased postoperative pain. This approach is particularly beneficial for patients considered high-risk for conventional surgery or those who prefer a less invasive option.

Mitral valve repair or replacement: Robotic technology is commonly employed for mitral valve repair or replacement surgeries. The mitral valve controls blood flow between the left atrium and left ventricle of the heart. Robotic-assisted techniques enable surgeons to repair or replace a diseased or malfunctioning mitral valve with enhanced precision, resulting in improved outcomes and reduced risks for patients.

Coronary Artery Bypass Grafting (CABG): Robotic systems are utilized in coronary artery bypass grafting procedures, which involve creating alternative routes for blood flow when coronary arteries are blocked or narrowed. Robotic-assisted techniques provide surgeons with greater visualization and dexterity to perform precise grafting, resulting in improved outcomes for patients with coronary artery disease.

Atrial Fibrillation (AF) Treatment: Robot-assisted surgery is used to perform surgical ablation procedures for the treatment of atrial fibrillation. This irregular heart rhythm can be managed by creating scar tissue in specific areas of the heart to disrupt abnormal electrical signals. Robotic technology allows for accurate placement of ablation lines, resulting in better outcomes and reduced risk of complications.

Cardiac Tumor Resection: Robotic systems are utilized in the resection of cardiac tumours, both benign and malignant. The enhanced visualization and precise movements offered by robotic surgery assist in the delicate removal of tumours while minimizing damage to surrounding healthy tissues. This approach allows for improved tumour removal and better preservation of heart function.

Pediatric Cardiac Surgery: Robotic heart surgery also finds applications in pediatric cardiac surgery. The smaller incisions and precise movements provided by robotic technology are particularly advantageous for delicate procedures in infants and children with congenital heart defects, enabling surgeons to perform complex repairs with improved outcomes and reduced risks.

Some cardiothoracic procedures that can be performed with robotic surgery include:

Thymectomy-  A thymectomy aims to remove the thymus gland, a small organ located in the chest, to manage conditions like myasthenia gravis, thymoma, or other autoimmune disorders. The procedure can help alleviate symptoms and potentially improve the patient's overall health by reducing the autoimmune response associated with these conditions.

Decortication- Decortication is performed to remove the fibrous or inflamed tissue surrounding the lungs, often due to conditions like pleural effusion or empyema. This helps improve lung expansion and function while reducing pain and breathing difficulties for the patient. Decortication is used to treat serious respiratory issues and improve overall lung health.

Bullectomy- A bullectomy removes abnormally large air-filled sacs called bullae from the lungs, often seen in conditions like chronic obstructive pulmonary disease (COPD). This surgery aims to alleviate breathing difficulties, reduce the risk of lung collapse, and improve overall lung function, especially in patients with advanced lung disease. Bullectomy is considered when conservative treatments and management strategies have been ineffective.

Lobectomy- Lobectomy entails the removal of a lobe of the lung, typically to treat lung cancer or other severe lung conditions. This helps eliminate diseased tissue, improve lung function, and potentially enhance the patient's overall quality of life.

Pneumonectomy- Pneumonectomy involves the removal of an entire lung, often necessary to treat extensive lung cancer or severe lung infections. This major surgery aims to eliminate diseased tissue but can significantly impact a patient's breathing capacity and function.

Tumour resection- Robotic surgery enables precise tumor resection by allowing surgeons to control robotic arms with enhanced dexterity and precision, minimizing damage to surrounding healthy tissue and improving patient outcomes. It offers less invasive options for complex tumor removals in various parts of the body.

Preparation

• The doctor will ask the patient about their personal and family medical history, allergies and medications.
• The doctor may conduct physical exams and order diagnostic, imaging and lab tests like blood tests, angiograms, exercise stress tests, cardiac catheterisation and more.
• Quit smoking before the procedure and try not to smoke after the procedure, for 6 weeks.
• The doctor may start or stop medications before the procedure.
• The care team will provide necessary details.

How is the procedure performed?

• General anaesthesia is administered.
• The doctor makes small incisions near the ribs.
• A tiny camera and surgical instruments are passed through the incision to conduct surgery.
• The doctor can visualise the heart and its surrounding structures in 3-D on a screen, which enables them to operate precisely.
• Once the surgery is complete, the incisions are closed with sutures and a bandage is applied over them.

Recovery

Recovering from robotic bypass surgery is relatively comfortable compared to traditional surgery.

Traditional surgery includes:

• 4-6 weeks of recovery.
• It is advised that patients do not lift heavy objects, engage in strenuous activities or operate heavy machinery.
• The doctor will provide pain medication so that the patient heals comfortably.
• Regular follow-ups are necessary to ensure no complications after the procedure.
• The doctor will inform the patient about the exercises they can perform after the patient recovers.
• Do take all the prescribed medicines on time to ensure proper recovery.

Robotic surgery involves:

• Faster recovery in about 1-2 weeks.
• Patient can lift weights as before and do all types of exercises on doctor's advise.
• Follow-up after 6 months.
• Minimal medications after surgery.

Alternate Name

Robotic Cardiac Surgery

FAQs

1. Who is a suitable candidate for robotic heart surgery?
Suitable candidates for robotic heart surgery are often those with specific heart conditions that can be addressed minimally invasively. The patient's overall health, pre-existing conditions and the complexity of the procedure influence eligibility.

2. What is the role of the surgeon during robotic heart surgery, and how does the robot assist?
During robotic heart surgery, the surgeon controls robotic arms, which assist with precise incisions, suturing, and maneuvering surgical instruments, enhancing precision and reducing invasiveness.

3. What are the common heart conditions treated with robotic surgery?
Common heart conditions treated with robotic surgery include mitral valve repairs, coronary artery bypass grafting (CABG), atrial septal defect closure, and some cardiac tumors.

4. Does robotic heart surgery take longer than traditional surgery?
Robotic heart surgery can sometimes take slightly longer than traditional surgery due to the setup and robotic-assisted techniques, but this can vary depending on the specific procedure.

5. Is robotic heart surgery covered by insurance?
Eligibility for robotic heart surgery varies by insurance plans, so it's essential to consult with your provider to determine coverage.

6. How long does it take to recover from robotic heart surgery?
Recovery time from robotic heart surgery varies depending on the procedure's complexity but generally involves a shorter hospital stay and faster return to normal activities compared to traditional surgery.

7. What is the duration of robotic heart surgery?
The duration of robotic heart surgery depends on the specific procedure, but it often takes several hours to complete.

Is robotic heart surgery performed with a bypass machine?
Robotic heart surgery can be performed with or without a bypass machine, depending on the surgical approach and the patient's individual needs.

Who is not a candidate for robotic heart surgery?
Ineligible candidates for robotic heart surgery often have complex heart conditions, obstructed chest anatomy, or other health factors that make the surgery risky or less effective. It's like when a doctor advises against a treatment because it could be harmful given a person's specific health situation. Individual assessment by a surgeon is crucial.

Why is there less blood loss with robotic-assisted surgery?
Robotic-assisted surgery typically results in less blood loss because the robotic instruments used in the procedure provide precise and controlled movements. This precision minimizes damage to blood vessels and tissues, reducing the risk of bleeding during surgery. Additionally, the surgeon can often make smaller incisions, which also contributes to reduced blood loss compared to traditional open surgery.

Review

Reviewed by Dr. Rajneesh Malhotra, Vice Chairman & Head, Cardiac Surgery (CTVS), Robotic Surgery.