This section is mainly intended for patients and/or family members that have been referred for robotic surgery or are considering obtaining a second opinion.  The first two educational videos give an overview of common practical questions that families often have – who are candidates, what are the pros and cons of doing surgery this way, what is the expected course of events prior/during/after surgery?  The video was obtained from the team at Univ of Arizona, but it still applies to patients at St. Francis.  Warning: The other videos on this page should be viewed only by those that aren’t disturbed by the sight of blood.

For those that aren’t sure but are still curious about what an actual robotic surgery is like, then I recommend the videos at the top of the list called “Video of Bypass Robotic Surgery” and “Robotic Harvest of Bilateral IMA”.  These are brief videos that illustrate the basic concepts of how robotic heart surgery is performed.

The remaining 4 videos each show a more sophisticated heart surgical procedure that can be done with a robot.  For example, repeat bypass and repeat valve surgery in someone that had a prior heart surgery done through the traditional sternal incision, valve repairs on a beating heart.  These are procedures that require years of experience in order to be able to tackle, but the video illustrates the advantages when this approach is taken – less bleeding, better visualization of the scar tissue, greater dexterity of the instruments.

Overview of robotic CT surgery

Discussion of robotic cardiac surgery including who are candidates, what are the pros and cons and what to expect during and after surgery.

Before Your Surgery

Presentation by nurse and NP who were responsible for taking care of patients who underwent robotic surgery.

Video of Robotic Bypass Surgery

This video demonstrates each of the steps of robotic heart bypass: 1) initial placement of the ports in between the ribs, 2) harvest of the internal mammary arteries, 3) hand sewn connections of the grafts to the coronary arteries, 4) angiogram at the completion of the case showing well-functioning grafts.

Robotic harvest of bilateral IMA

Brief video demonstrating the surgeon’s view while harvesting the right internal mammary artery using the surgical robot.

Redo coronary bypass using robotics

Video showing the dissection of the right internal mammary artery in a patient with prior failed CABG.  The RIMA had to be dissected away from a cancerous mass that was later resected using the robot.  After dissecting the heart away from the retrosternal space, the RIMA was grafted onto the LAD.

REDO TRICUSPID REPAIR

This full length video shows the utility of robotics in redo heart surgery.  Blood loss is reduced and the precision of dissection is improved over open techniques, which helps reduce inadvertent injury due to excessive scar tissue.  The valve is repaired on a beating heart.

REDO MITRAL

This full length video shows the use of robotics in a redo mitral valve repair procedure.  Because the left atrium is opened, the heart is arrested.

Repeat mitral valve repair

This patient had a prior mitral valve repair that failed, resulting in recurrent severe mitral regurgitation.  Robotics was used to perform a repeat mitral valve repair that was successful at eliminating the regurgitation.

Robotic removal of left atrial mass

Patient with a left atrial mass that was resected using a robotic technique.  The operation shown is on a beating heart and the view obtained by the robotic camera is through the left atrium of the heart.  With the use of cardiopulmonary bypass, the heart becomes empty of blood and the left atrium can then be opened while the heart was still beating.  This minimized the risk of heart injury during this brief operation to remove the mass.

Redo robotic heart surgery

Patient with prior failed bypass graft to a coronary artery on the front of the heart called the LAD. The prior procedure was done through a large incision in the front of the chest called a sternotomy, which creates scar tissue that fuses the heart to the back of the sternum and makes it dangerous to reopen the chest via the sternum.  The surgical plan was to use the right internal mammary artery as a bypass graft for this LAD vessel.  As illustrated in this full length (50 minute) video, the use of robotics allows the scar tissue to safely be addressed with little risk of injuring the heart and causing minimal bleeding.  With this approach, the right mammary artery, which was the sole source of blood supply to the sternum, is then harvested and grafted onto the LAD.  There is no risk of poor healing of the sternal bone because there is no sternal incision.

Two vessel robotic bypass using both internal mammary arteries

Two vessel coronary artery bypass procedure done on a young patient with diabetes using bilateral IMA vessels as the bypass conduits.  Normally, these two vessels are not used for bypass grafts because this creates an increased risk of sternal healing difficulties.  When using robotics, there is no sternal incision and therefore these optimal conduits can be used without that added risk.  This 5 minute video provides a step-by-step narration on how this procedure is efficiently done.

May 28, 2018 @ 6:21 pm