Article Type : Letter to the Editor
Authors : Mitra M
Keywords : Cardiac; Heart; Robot; Surgery; Robotic cardiovascular surgery
In
a robotic cardiovascular surgery; most likely cardiac surgeon’s specialization
will be in treatment of heart valve disorders, atrial fibrillation coronary
artery disease, and other cardiac diseases. Advantages of robotic
cardiovascular surgery are less invasive methods to reduce pain, disability,
and recovery time. Some robotic heart surgeries are performed without use of
heart-lung bypass machine, hence minimizing risk of stroke and other
neurological complications. Few medical robotic cardiovascular surgeries are
reviewed.
Although having steep learning curves and added cost involved
for mitral valve repair for robotic surgery and fact is that common
heart operations are performed using robot aided surgery. The
robotic process for mitral valve surgery took 224 minutes.
Robotic method for mitral valve surgery had similar outcomes
comparatively with conventional approach except that there were
half number of onward discharges to further care 7% to 15% and
one day less spent in hospital. Since all the cases were reviewed
after surgery had taken place, findings cannot establish cause and
caution. Advantages and disadvantages to each of the techniques
resulted to authors to conclude: “From a patient perceptive, all
techniques provide better outcomes, hence patient preference and
surgeon experience should dictate the method for mitral valve
surgery” [1-2].
This study depicts patients with multi-vessel coronary disease
including obstruction of the left anterior descending coronary
artery, the main artery in front of the heart. Robotic surgery
encompasses making three small incisions, each about 1 cm (1/2
inch) long in the left side of the patient’s chest. To view a 3-
dimensional scope with 10x magnification was included in the
middle port with robotic right and left arms in other ports. The
mechanical system has a powerful computer interface that allows
surgeons to sit at the console with full vision of the operative
field. Surgeon’s as usual surgical hand movements are rendered
through the tiny robotic arms inside the patient. Robotic arms
with identical instruments at their tips, precisely follow surgeon’s
hand movements [3-4].
Figures 1a): Left ventricle chamber measurement in the parasternal long-axis view [3].
Figures 1b): Color doppler demonstrating central aortic regurgitation [3].
Figures 1c): Tricuspid regurgitant jet evident on color Doppler imaging [3].
Figures 1d): Peak velocity of the tricuspid regurgitant jet (used to estimate pulmonary artery systolic
pressure) – this is unable to be adequately
detected in approximately 30% of patients undergoing echocardiography [3].
Figures 2: Illustrates Soft Robotic
Heart Graphs [6].