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Department of Surgery

Department of Surgery

Robotic-Assisted Cardiothoracic Surgery FAQs

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W. Douglas Boyd, M.D.

W. Douglas Boyd, M.D.

Cardiothoracic Surgery

 

Elizabeth David, M.D.

Elizabeth David, M.D.

General Thoracic Surgery

 

What is robotic-assisted surgery?

daVinci robotic systemUC Davis Medical Center surgeons have been using robotic-assisted procedures since 2004. This minimally invasive, video-assisted technique has been used to treat a variety of conditions, ranging from prostate and ovarian cancers to conditions of the upper GI tract. UC Davis cardiothoracic surgeons are now using the robotic system to treat coronary artery disease.

The surgical robot is an operating room device completely controlled by a skilled surgeon who manipulates mechanical arms from a console near the patient’s bed. The procedure uses much smaller incisions than traditional “open” surgery, which helps reduce blood loss and speed postoperative recovery times. UC Davis surgeons perform dozens of robotic-assisted procedures each month using a state-of-the-art, da Vinci® surgical system.

How does robotic-assisted surgery work?

daVinci controls closeupWorking from a special console in the operating room, a surgeon operates several precision-guided robotic arms that hold and manipulate miniaturized instruments that are inserted through several keyhole-sized incisions in the patient. A small video camera, inserted through another tiny incision, provides surgeons with a magnified, 3-D image of the operating site. This expansive view allows doctors to see and avoid surrounding nerves and muscle. The robotic arms, with their full 360-degree rotation capabilities, enable surgical instruments to be moved with greater precision, flexibility and range of motion than can be done in a standard, minimally invasive laparoscopy.

The procedure is done under general anesthesia. Patients typically experience minimal blood loss and avoid the need for blood transfusions. Depending on the complexity of the condition being treated, patients may only have to spend a short time in the hospital. They may be discharged on the day when laboratory test results are acceptable, pain is controlled and they are able to retain liquids.

What are the benefits to a patient?

Patients typically experience significantly less pain and less blood loss when compared to conventional “open incision” procedures. Patients also tend to enjoy quicker recovery times. A traditional, open surgery requires several days of hospitalization and a recovery period that can last several months. While every case is unique, the return to normal activities (except for lifting heavy objects and strenuous exercise) following a robotic-assisted bypass procedure may occur in a matter of weeks.

Why is there less blood loss with robotic-assisted surgery?

Open surgery incision vs. robotics-assisted surgery incision pointsThe use of the robotic surgical system means a less traumatic operation. The coronary artery bypass can be done thoracoscopically, between the ribs, rather than with a sternotomy, which requires an 8- to 10-inch incision down the chest, cutting through the breastbone (sternum) and opening the chest to access the arteries surrounding the heart.

What are the risks of robotic-assisted surgery?

As with any major surgery done under general anesthesia, there is a certain amount of risk, including heart attack, stroke and death. Preoperative assessment of a patient’s overall health is part of the standard surgical evaluation at UC Davis Medical Center.

What are the criteria for robotic-assisted surgery?

The decision to surgically treat a patient involves many considerations. Not every patient is an appropriate candidate for a minimally invasive procedure. UC Davis surgeons work closely with every patient, discussing treatment options and helping them decide on the best course of action, which may include robotic-assisted surgery.

The type of treatment recommended for a patient’s condition always depends on many factors, including the type and severity of heart disease, age, medical history and lifestyle. Diagnostic tests are required to determine if you are an appropriate candidate for robotic-assisted cardiac surgery. Your surgeon will review the results of these tests to determine if the robotic-assisted heart procedure is the right treatment approach for you.

What cardiac conditions can be treated with robotic-assisted surgery?

Led by Dr. W. Douglas Boyd, who performed the world's first closed-chest robotic-assisted, beating-heart, coronary artery bypass graft in 1999, the cardiac team currently offers robotic-assisted surgery for patients suffering from coronary artery disease. The team can do thoracoscopic, multi-vessel revascularization and it often collaborates with UC Davis specialists in cardiovascular medicine, who provide complementary services such as angioplasty and stenting, to offer every patient the full range of minimally invasive medical options.