Minimally Invasive and Robotic Valve Procedure

The heart consists of four types of valves, namely the mitral valve, tricuspid valve, aortic valve and pulmonic valve. These valves act as gates, allowing the unidirectional flow of blood within the heart. Certain diseases such as valve regurgitation (weak valves that cause blood leakage) or valve stenosis (stiff, inflexible or fused valve flaps that limit blood flow) can disrupt the normal flow of blood. Such damaged heart valves can be repaired or replaced by minimally invasive robot-assisted procedures.

A robotically-assisted heart surgery, also called closed chest heart surgery, is a type of minimally invasive surgery that uses the help of a robotic system to conduct the surgery. It is widely used to perform complex heart surgeries.

Procedure

Robotic surgery is performed under general anaesthesia. Your surgeon makes small incisions (of less than 2 inches) and inserts an endoscope (a flexible tube with a small camera at the end) and other instruments through them. These instruments are held by robotic arms that are controlled by your surgeon. The surgeon’s every move (of hands and wrists) is recognised by a computerised system that manipulates and translates them into corresponding scaled and accurate movements that are mimicked by the robotic arms. Your surgeon will always be in control over the instruments throughout the surgery; the robotic arms cannot move on their own.

With the help of the endoscope, your surgeon can clearly view the valves and leaflets as 3D images on a computer screen. With the help of the other surgical instruments, your surgeon exposes and opens the pericardium (a thin sac around the heart). Your surgeon may repair or replace the flaps of the malfunctioning valve to enable its normal functioning.

Post-operative Care

Following the surgical procedure, you may experience pain or discomfort for which your surgeon may prescribe medications. You may be allowed to go home after 2 to 5 days. You can usually resume normal activities and return to work within 2 to 4 weeks after the surgery. To maintain a healthy heart, you will be advised to take your prescribed medications and make a few lifestyle changes like quitting smoking, exercising regularly, maintaining a healthy weight and eating a healthy diet.

Complications

The complications of robotic valve procedure are uncommon but as with any surgery, complications can occur. They may include

• Bleeding
• Stroke
• Heart attack
• Transient ischemic attack (neurological dysfunction due to loss of blood flow)
• Heart rhythm problems
• Infection in valves, chest, bladder or kidneys
• Damage to adjacent tissues or organs

Advantages

The benefits of robotically-assisted surgery outweigh that of traditional surgery. The benefits of minimally invasive and robotic procedures are:

• Smaller incision as opposed to the large opening of traditional surgery that requires the separation of the breast bone and ribs
• Less pain
• Minimal scarring
• Less bleeding
• Short recovery time
• Shorter hospital stay
• Controlled precision of equipment that renders excellent outcomes

Robotic arm movements are more precise than a surgeon’s natural hand movements.