Meet "daVinci". She happens to be our resident robot. For years, Penn Heart and Vascular surgeons have been perfecting techniques with this technology on both common and rare cardiovascular procedures, giving patients an alternative to the traditional surgical approach.
Dr. Pavan Atluri, a cardiac surgeon and director of Penn's Minimally Invasive and Robotic Cardiac Surgery Program, answers questions on robotic surgery.
Questions and Answers about Robotic Surgery
Who performs robotic surgery, the surgeon or the robot?
During robotic surgery, the robot works as an extension of the surgeon, which allows us to work through very small incisions or ports. There are two robotic "arms" which both go through the incision (between 2 to 2.5 centimeters). Each of these arms has a camera at the end that sends images to a video monitor or console to help guide the surgeons.
There are two surgeons in the operating room, one controlling the robot and its movements and one directly next to the patient. The surgeon controlling the robot looks through the console that combines two separate images to create a highly detailed, 3D-image of the heart. It gives us a lot more precision and an ability to work through small spaces.
What kind of surgeries can be performed robotically?
The most common surgery that we do is the robotic mitral valve operation, both repairs and replacements.
We have also excised tumors from inside the heart and repaired holes in the heart. Outside of the heart, the robot is able to perform bypass surgery through small incisions and avoid the traditional sternotomy (long incision made along the sternum).
Who is a candidate for robotic heart surgery?
More often than not patients are candidates for this type of procedure. There is a very small population of patients that are not well suited for robotic procedures. The patients who are not ideal candidates for robotic surgery often have issues in several areas of the heart and would benefit more from an open heart procedure. And in those cases, Penn has the experience and outcomes for open-heart related surgeries.
At the end of the day, it always comes down to patient preference. I spend a lot of time with patients, telling them the risks and benefits of the operation and explaining what is involved. The first step is for the patient to decide this is something they want to do. After they make this decision, we go through an extensive screening process to make sure that we avoid any of the complications that may arise.
What are the benefits of robotic surgery?
One of the most visible benefits of minimally-invasive robotic heart surgery is the actual incision. It is much smaller than a long incision down the chest. The other advantages are in terms of recovery. It is a much more rapid recovery and several of my patients will be ready to resume normal activities within a couple of weeks of surgery, and that includes going back to work and going about their daily activities. It has been a really nice improvement in terms of how quickly patients bounce back from the operation.
What's Penn's experience with robotic heart surgery?
The choice to seek out a surgeon and healthcare facility familiar with robotic heart surgery is an extremely important one. At Penn, we've had this technology for many years. But, even more important is the experience of the people behind these robots. There are only a small number of cardiac surgeons in the country that are performing and have a certain level of expertise with robotic procedures.
For us at Penn, we strive for not just an immediate repair, but also long-term health for a patient's entire life.