| Reasons for Procedure
| Possible Complications
| What to Expect
| Call Your Doctor
A doctor guides robotic arms to do surgery on the heart. The surgery is done through several tiny keyhole incisions.
Reasons for Procedure
Robot-assisted cardiac procedures are done to treat a variety of conditions:
mitral valve repair
may be used to treat:
—narrowing of the mitral valve
- Regurgitation—leakage of the mitral valve
coronary artery bypass grafting
may be used to treat:
- Blockages in the heart’s arteries
Severe chest pain such as
that has not improved with medications
atrial septal defect
repair may be used to treat a hole between the upper chambers of the heart that does not close properly during fetal development.
lead placement may be used 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.
Copyright © Nucleus Medical Media, Inc.
Benefits of robot-assisted cardiac procedures may include:
- Increased range of motion with the robotic arms
- Ability to filter out human hand tremor and translate the doctor’s larger hand movements into smaller ones
to the body
- Shorter hospital stay
- Faster recovery
Complications are rare, but no procedure is completely free of risk. If you are planning to have a robot-assisted cardiac procedure, your doctor will review a list of possible complications, which may include:
- Damage to nearby organs or structures in the chest
- Blood clots
- Anesthesia-related problems
Some factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the surgery.
What to Expect
Depending on the reason for your surgery, your doctor may do the following:
Leading up to the procedure:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, such as:
- Anti-inflammatory drugs such as ibuprofen
- Blood thinners
- Anti-platelet medications
- Take antibiotics if instructed.
- Follow a special diet if instructed.
- Shower the night before using antibacterial soap if instructed.
- Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.
- Eat a light meal the night before. Do not eat or drink anything after midnight.
There are two options for anesthesia:
- General anesthesia
—blocks pain and keeps you asleep through the surgery
- Local anesthesia with sedation—just the area that is being operated on is numbed, given as an injection
Several keyhole openings will be cut in the spaces between the ribs. Next, a small camera will be passed through one of the incisions. This small camera is called an endoscope. It will light, magnify, and project an image of the organs onto a monitor. The endoscope will be attached to one of the robotic arms. The other arms will hold instruments for grasping, cutting, dissecting, and suturing. These may include:
While sitting at a console near the operating table, the doctor will use lenses to look at a magnified 3D image of the inside of the chest. Another doctor will stay by the operating table and adjust the camera and instruments. The robotic arms and tools will be guided with joystick-like controls and foot pedals. After the instruments are removed, incisions will be closed with sutures or staples.
After the procedure, you will be:
- Moved to the intensive care unit (ICU)
- Closely monitored
- Encouraged to sit up and move around soon after surgery
Usually 1-4 hours, depending on the procedure
You will have pain and soreness during recovery. Ask your doctor about pain medicine.
This procedure is done in a hospital setting. The usual length of stay depends on the procedure you had done. Your doctor may need to keep you longer if you have any problems.
When you return home, do the following to help ensure a smooth recovery:
- Follow your doctor's guidelines on taking medication. You may need to take antibiotics.
- Do deep breathing and coughing exercises.
- Follow a special diet.
- Wash the incisions with mild soap and water.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Limit certain activities such as driving and strenuous activity.
- Enroll in a cardiac rehabilitation program.
- Be sure to follow your doctor's instructions.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
- Cough, shortness of breath, or chest pain
- Rapid weight gain
- Pain and/or swelling in your feet, calves, or legs
- Headache, feeling faint or lightheaded
- Other worrisome symptoms
In case of an emergency, call for medical help right away.
About minimally invasive and robotic cardiac surgery. Columbia University Medical Center, Department of Surgery website. Available at:
http://www.columbiasurgery.org/pat/mirobotic/procedures.html. Accessed July 25, 2013.
Atrial septic defect repair. Inova Health System website. Available at:
http://www.inova.org/healthcare-services/pediatrics/types-of-services/pediatric-cardiovascular-program/procedures/atrial-septic-defect-repair.jsp. Accessed July 25, 2013.
Mitral valve repair. Society of Thoracic Surgeons website. Available at:
http://www.sts.org/sections/patientinformation/valvesurgery/mitralvalverepair/. Accessed July 25, 2013.
Robot-assisted heart surgery: how it works. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/heart/services/surgery/robotically-assisted-heart-surgery.aspx. Accessed July 25, 2013.
Last reviewed July 2013 by Marcin Chwistek, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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