Minimally Invasive Heart Surgery
Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
Like traditional open-heart surgery, minimally invasive heart surgery corrects many problems affecting the blood vessels and structures within the heart. However, instead of a 7- to 8-inch incision through the chest and breastbone, minimally invasive heart surgery is performed through a few small incisions in the chest, each about a half-inch long. The breastbone remains intact.
Compared to open-heart surgery, minimally invasive heart surgery allows patients to experience less pain and blood loss as well as shorter hospital stays and recovery times.
Surgeons at Aurora Health Care use the highly specialized da Vinci® Surgical System to perform several types of robotically assisted heart surgery. Some of these procedures include:
- Atrial septal defect
- Mitral valve repair or replacement
- Some cases of coronary artery bypass grafting
During da Vinci procedures, a surgeon sits at a console, while the patient lies on a nearby surgical cart that has four interactive robotic arms. From the console, the surgeon manipulates the robotic arms, which hold the surgical tools, as if they were his own hands and wrists.
The surgeon makes several incisions in the chest, usually underneath the right breast and down the side. A tiny camera is placed inside the chest through one of the incisions, providing the surgeon with a 3-D view of surgical site on the console monitor. Because of the camera’s magnification and the instruments’ small size and flexibility, robotic heart surgeries allow for great precision.
Preparing for Robotic Heart Surgery
In the days or weeks before your robotic heart surgery, your doctor is likely to request the following pre-operative tests:
- Cardiac catheterization to check for blockages in the blood vessels of the heart (if not recently done)
- Carotid ultrasound to check the arteries in your neck for blockages, which could potentially interfere with blood flow to the brain and increase your stroke risk
- Chest X-rays to help identify lung/heart abnormalities before your surgery
- Dental examination if you haven’t had one recently
- Echocardiogram (cardiac ultrasound testing) to check your heart muscle strength and the function of your heart valves
- Electrocardiograph testing (EKG) to check your heart rate and rhythm
- Lab testing to check your kidney function, liver function, blood count, urine, thyroid function and blood type (in case a transfusion is needed during your surgery)
On the day before your robotic heart surgery:
- To prevent infection, your will be asked to wash your chest and legs using a special soap that helps kill bacteria. You may also be instructed to clip your chest and/or leg hair.
- You will be given instructions on which medications to STOP taking and which medications you can take the morning of surgery. Important medications to check prior to taking are those for diabetes, blood thinners, medications that make you urinate more frequently and blood pressure medications.
On the morning of your robotic heart surgery, you will be asked to:
- Arrive at the hospital as directed, usually about 2 hours before your scheduled surgery
- Bring all your medications with you to ensure that your home medication list is correct
- Have your blood pressure and vital signs checked when you are admitted
- Refrain from eating or drinking after midnight
- Take only those medications your doctor has allowed with only a sip of water
Immediately before your robotic heart surgery:
When you are ready for surgery, you will be taken to the pre-op holding area where you will meet the anesthesiologist. As you wait, a nurse will be available to answer any questions.
You will have an IV placed in your arm that will deliver antibiotics. The anesthesiologist will give you medicine to help you relax and make you sleepy.
You may feel cold when you are moved to the operating room and will receive extra blankets to keep warm. You will be transferred to a hard table and, once in position, will receive anesthesia and be prepared for surgery.
During Your Robotic Heart Surgery
Once anesthesia is given, you will be completely asleep. Your anesthesiologist will put in a central line, which is a large IV for delivering medications. Another line will be used to monitor your heart function.
To help with breathing during the surgery, you will have a breathing tube that is connected to a ventilator (breathing machine). You will also have a bladder catheter.
In addition to your anesthesiologist and surgeon, you will have surgical assistants, nurses and a physician assistant helping with your procedure. The average surgery takes about 3 – 5 hours, depending on the amount of work that needs to be done. You will have 4-5 small incisions, about ½ inch in length, on the chest. There will also be a small drainage tube in your chest that will likely be removed on the day after your surgery.
During your surgery, you will be connected to a heart-lung bypass machine, which allows the surgeon to stop your heart from beating and moves the blood away from your heart.
After surgery is complete, the small incisions are closed with sutures. Drainage tubes will be put in your chest cavity to drain blood and fluid.
Robotic Heart Surgery Risks
All surgeries have potential risks and complications. Some risks are higher in older adults and people with other health concerns. Your doctor will explain your risks in greater detail. Potential robotic heart surgery risks include:
- Breathing/kidney problems
- Heart arrhythmias (irregular heartbeat)
- Infection (resulting from surgical wounds, pneumonia or a bladder catheter causing a urinary infection)
- Stroke (with possible short- or long-term effects, depending on its severity)
Robotic Heart Surgery Recovery
After your surgery, you will be taken from the operating room to the intensive care unit (ICU). You will have a breathing tube in place until you wake up from general anesthesia. After surgery, wires and tubes, including your breathing tube, will be removed as your condition stabilizes. Most patients are up in the chair on the evening of surgery.
Once your breathing tube is removed, your heart rhythm and blood pressure stablize, and special intravenous medications are no longer needed, you will be moved out of the ICU.
You can expect to remain in the hospital 2 – 3 days following surgery. You will begin an exercise program the day after surgery. Blood pressure, oxygen levels, temperature and heart rhythm will be monitored. Medication adjustments will be made while in the hospital.
Pain will be controlled with pain medication starting immediately after surgery. This will help you to increase your activity and comfortably participate in rehabilitation exercises.
Other prescriptions, including pain medication, will be given at discharge.
Nationally Recognized for Robotic Heart Surgery
The da Vinci robotic system requires a special team of operating room staff who are specially trained in the use of this equipment. At Aurora Health Care, we have teams with extensive experience performing minimally invasive heart surgeries. Our teams include a surgeon, anesthesiologist, operating room nurses, surgical techs, physician assistants, nurse practitioners and nurses
You will see members of your team at your before surgery, during your surgery and hospital stay, and afterward at follow-up visits to ensure you get the care you need at every step of your procedure.
Aurora also has surgeons who have been recognized for their patients having minimally invasive surgeries and robotic heart surgeries. they are involved in research and trials to stay on the cutting edge of technology and techniques for minimally invasive and robotic heart surgeries
To take care of your other medical needs, Aurora surgeons work closely with other specialists, including cardiologists and doctors who specialize in diabetes, lung conditions and other disorders.
Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.