U.Va. Health has launched Virginia’s first dedicated robotic heart surgery program as new technology and procedures offer patients less invasive alternatives to traditional open-heart surgery.
“We’re using a series of robotic instruments that are inserted into the patient and controlled by the surgeon, which allow us to access the heart and do operations that are traditionally done by opening the chest,” said Dr. Michael Ibrahim, director of the robotic cardiac surgery program at U.Va. Health.
Typically, after traditional open-heart surgery, “patients can’t use their arms to get up and out of a chair, they can’t carry more than 10 pounds for several weeks or months,” Ibrahim said.
Conversely, “There are really no restrictions after robotic cardiac surgery apart from what you feel able to do.”
Ibrahim said three or four instruments are typically used during robotic surgery.
“I’ll be sitting down on a console and moving various instruments, forceps, a needle driver, scissors, and so on, and that allows me to do the operation that I would normally do with my own hands.”
Ibrahim said the wrists of the da Vinci 5 robotic surgical system are “more than a human wrist, so the precision you get is significantly better.”
In addition, while traditional open-heart procedures prioritize what trained surgeons feel with their hands, robotic surgery offers superior visualization.
“The camera is really high definition and you can drive it into the heart itself,” Ibrahim said. “So you can see from a very large scale and incredible amounts of detail.”
Ibrahim, who had a long history of performing robotic procedures before coming to U.Va., said increasingly complex cardiac surgeries are being done with the robot.
“The types of operations that we do robotically are coronary artery bypass surgery, mitral valve repair, which is what our first patient was,” Ibrahim said.
In addition, mitral valve replacement, other valve repair and replacement in the heart, including aortic valve repair and replacement and tricuspid valve repair and replacement.
Ibrahim said a growing number of patients are eligible for robotic surgery.
“We start with the starting point that all patients are candidates,” he said.
Patients who are ruled out include those with prior cardiac operations, chest wall deformities and high-risk patients.
“Getting a CT scan allows us to check that there’s a safe way of putting the patient on the heart lung machine,” which takes over the work of pumping blood and adding oxygen during the procedure.
“We see patients go home seven to 10 days after open heart surgery,” Ibrahim said. However, with the less-invasive robotic surgery, “patients are being discharged typically around day three.”
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