Robotic and Minimally Invasive Cardiac Surgery: The New Standard
Nov 19, 2021 Cedars-Sinai Staff
The Smidt Heart Institute is leading the way in robotic and minimally invasive cardiac surgery. Robotic and minimally invasive heart surgery involves making small incisions in the side of the chest between the ribs to reach the heart, which is a preferred method to the traditional approach of cutting through the breastbone.
Robotic and minimally invasive procedures can be performed for various pathologies of the heart and aorta. Compared to standard open-heart surgery, these procedures result in less pain and quicker recovery times. For many patients, this means a faster return to both work and normal physical activity.
"The Department of Cardiac Surgery at Cedars-Sinai is world-renowned for its continued innovation in robotic and minimally invasive heart surgery."
Who is a candidate for robotic and minimally invasive heart surgery?
In the past, candidacy for minimally invasive heart surgery was limited by several factors. Considerations included the type and severity of the disease, patient age, medical history and lifestyle of the patient. However, with current advances in minimally invasive methods, there are now far fewer limitations and our ability to perform either a robotic or minimally invasive procedure is rarely affected. The latest advancements in robotic and minimally invasive technologies have dramatically increased the accessibility of these methods for patients with many heart pathologies.
Types of robotic and minimally invasive heart surgery
The Department of Cardiac Surgery at Cedars-Sinai is world-renowned for its continued innovation in robotic and minimally invasive heart surgery. The minimally invasive methodologies offered at Cedars-Sinai treat all forms of heart disease. The most common form of minimally invasive heart surgery at Cedars-Sinai is valve surgery, with the vast majority being done robotically. While robotic valve surgery is a prominent and preferred technique, Cedars-Sinai uses minimally invasive techniques in a vast array of cardiac pathologies including robotically assisted CABGs, atrial septal defect closures, septal myectomies, atrial fibrillations and tumor resections. In addition to revolutionizing traditional, fully open surgery, minimally invasive techniques are also transforming aortic surgery. The surgical experts specialize in replacement of the ascending aorta via a right anterior thoracotomy. This approach is minimally invasive compared to the traditional standard midline sternotomy. The Smidt Heart Institute is one of few centers in the nation offering this groundbreaking procedure.
Advantages of robotic and minimally invasive approaches
A 65-year-old woman with severe aortic valve stenosis presented with past medical history of hypertension, hyperlipidemia, coronary artery disease and septal hypertrophy. She sought out five medical centers for potential minimally invasive treatment options with no success. Our robotic and minimally invasive program individualized the care of this complex patient by performing an aortic valve replacement, septal myectomy, subaortic membrane resection and root enlargement via right anterior mini thoracotomy. This minimally invasive approach resulted in a successful recovery with a four-day hospital stay and a return to normal activity in less than two weeks.
The benefits of minimally invasive techniques are numerous and include the cosmetic benefits of smaller incisions with less scarring (Figure 1), decreased risk of bleeding and infection, and minimized pain. Shorter hospital stays are another main advantage of minimally invasive and robotic surgeries, with the average length of stay of three to five days, as compared to seven to 10 days for traditional heart surgeries. Recovery times are also reduced, with patients given the benefit of two-week recoveries compared to eight-week recoveries with fully open approaches. The ability to treat more patients with greater ease in less time means enhanced clinical efficiency. Minimally invasive and robotic approaches are transforming the world of surgery as we know it, creating opportunity for a brighter future and better tomorrow.