How is the robotic heart procedure performed?

During totally endoscopic robotic mitral valve surgery, we typically use a system of peripheral catheters to rest the heart while we work on it.  This allows us to avoid larger incisions and simplifies the procedure.

During totally endoscopic robotic mitral valve surgery, we typically use a system of peripheral catheters to rest the heart while we work on it. This allows us to avoid larger incisions and simplifies the procedure.

For robotic intracardiac procedures such as mitral valve surgery, tiny incisions (7-15mm) are made in the side of your chest and robotic ports are placed.  The robotic arms are attached to these ports and robotic instruments inserted.  The surgeon then goes to the robotic console and completely controls these instruments, performing the surgery using the robotic tools.  The robotic does not do anything independently-the surgeon is in control of the robotic instruments at all times.  The surgeon is near the patient.  Some portions of the procedure are performed in concert with trained personnel at the bedside also doing various tasks under supervision of the surgeon.  In addition, your surgery may require the use of the heart lung machine along with catheters that are used to stop your heart so that it can be worked on.

Da Vinci Robotic System

Da Vinci Robotic Surgical System. Click to enlarge. ©2009 Intuitive Surgical, Inc.)

This catheter-based system to bypass the heart facilitates intra-cardiac procedures and sometimes coronary artery bypass procedures.  At the end of a robotic procedure, the robotic arms and ports are removed and the incisions closed.  A drainage tube is left in the chest to remove any blood or air that accumulates.

The robotic system is only a tool.  It simply allows the surgeon to have the same agility with the ends of the instruments that he or she would have with their hands.  Non-robotic minimally invasive instruments do not have the same amount of dexterity and are harder to use.


Robotic coronary artery bypass procedures can be performed with only tiny incisions (TECAB-totally endoscopic coronary artery bypass).  This procedure involves using the robot to do everything including sewing the bypass to the target artery with the robotic instruments.   It is ideal to have your surgeon describe exactly what they plan to do.  Also keep in mind that if in the operating room, things are not going ideally, the surgeon should consider conversion to a standard sternotomy (breast plate) incision.  This decision is a sign of great wisdom in right circumstances!  Continuing a suboptimal minimally invasive procedure when a standard approve would deliver a perfect result is not the way I would want to be treated.


← How is the robotic heart procedure performed?
T. Sloane Guy, MD

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