The length of the operation varies. The actual procedure itself that I perform is about 3 hours. There is a lot of work done prior to me coming in the room to start the procedure and afterwards.

The general schedule for robotic mitral valve surgery is this:

1. 6:00 AM The patient arrives at the hospital and checks in
2. 7:00 AM I will see you and sign paperwork allowing things to proceed
3. 7:00-7:30 AM The patient gets a nerve block by anesthesia pain experts (helps reduce pain after surgery)
4: 7:30 The patient goes into the operating room
5. 7:30-9:30 Anesthesia puts the patient to sleep and places various special lines to make the procedure possible
6: 9:30 First skin incision
7: 12:00-2:00 PM Operation is concluded and patient transported to the ICU

Critics of these procedures will often say robotics “takes longer” and this is true. However, there is absolutely no evidence that this results in inferior outcomes. In fact, there is evidence to show earlier extubation (removal of the breathing tube/ventilator), earlier discharge from the intensive care unit (ICU), early discharge from the hospital, earlier return to work, decreased bleeding and pain. I think the reality is that a full sternotomy (breast plate divided) traditional approach does make life easier for the surgeon and the surgical team but not for you. As we in healthcare start to focus less on ourselves and more on you and your needs, it becomes obvious that minimally invasive approaches are the way to go provided they are as safe as a standard operation. Of course there are patients for whom a minimally invasive approach is inappropriate and there is nothing wrong with a standard operation. I like to tell my patients that for every way to do mitral valve surgery, I have done them all and have surgeons I know and would trust with my family still doing it that way. But the reality is that endoscopic robotic heart surgery is the least invasive surgical procedure there is at this point.

Category: Questions about Robotic Cardiac Surgery Procedures
T. Sloane Guy, MD

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