In March, an Allegheny General Hospital patient became the first there to undergo robotically-assisted minimally invasive coronary bypass surgery. The procedure is thought to be less traumatic to the body and allows for faster recovery times for patients.
"If you look at traditional surgery, the standard approach is through an incision that goes through the front of the chest. The breast bone is divided. Traditionally that operation is performed on the heart-lung machine, though it can also be performed off the heart-lung machine. The robotic approach is somewhat different because not only its outward appearance, but what occurs on the inside as well. It does its work while the heart is still beating, needing no heart-lung machine," said Walter McGregor, MD, director of the AGH robotic cardiac surgery program.
The outside difference is robotic-assisted surgery only requires a small incision, and McGregor believes patients who undergo this type of surgery recover more quickly.
"Because of its minimally-invasive approach, and I think in part because of its off-pump or beating-heart nature, meaning not using the heart-lung machine, patients seem to recover back to their baseline lifestyle a little faster once they're out of the hospital," he said.
Not everyone who needs open-heart surgery qualifies for the robotic-assisted procedure. McGregor said the ideal candidate is generally someone with single vessel disease or someone with multiple vessel disease who can be treated with a combination of surgery and coronary stent implantation.
McGregor said it's still too early to know if the increased costs associated with robotic-assisted surgery are worth it in the long run, but added the technology likely isn't going anywhere, so time will tell.
"What the robot allows is true open surgical technique because of the versatility of the instruments, but through simple, small incisions. Because of its versatility and dexterity, I personally believe it will find greater and greater application over the next decade," he said.
McGregor said the benefits of robotic heart surgery are considerable, including lower infection risk, less scarring, shorter hospital stays, reduced blood loss, and a faster recovery. In addition, he said, this type of surgery also mitigates complications of stopping the heart and using a heart lung machine, which can include kidney failure and respiratory distress.