Surgeons at El Camino Hospital are gearing up to perform a variety of heart operations using the da Vinci robotic surgery system. The da Vinci system, which allows the surgeon to visualize the body cavity in 3D while controlling finely tuned instruments from a workstation, has already been used to perform prostatectomies, thoracic surgeries, and other procedures at the hospital.
"Our patients' survival rates are outstanding for conventional coronary artery bypass graft (CABG), aortic surgery, mitral valve repair or reconstruction, and aneurysm repair," says Ramin Beygui, MD, medical director of cardiac surgery at the hospital. "Our isolated CABG mortality has been zero percent for the past two years. With the robot, our goal is to provide the same quality and results but through a smaller incision."
This offers advantages including less postoperative pain, quicker recovery, lower chance of infection, and a smaller scar, according to Beygui. Not all patients or all procedures are suitable for the new approach, however.
da Vinci Robotic Surgery System
"Patients with multiple valve disease, multiple coronary artery disease in addition to valve disease, or those with previous surgeries may not be good candidates for robotic mitral valve replacement," he explains. A history of previous surgery is a problem, for example, because patients tend to form scar tissue that makes it harder for the surgeon to navigate inside the chest cavity using the robotic camera.
Initially, Beygui and colleagues such as thoracic surgeon Bruce Reitz, MD, will focus on procedures such as repair or replacement of the mitral valve, coronary reconstruction, and reoperations for patients whose previous surgeries need attention.
Technical proficiency in robotic surgery entails a long learning curve, and Beygui is dedicated to a process that will bring everyone in the department to excellence step by step. "I have experience from the inception of the robotic surgery system at UCLA, where I was on staff before I came to El Camino Hospital," says Beygui. "We will start with less-complicated procedures as the operating room staff and surgeons become comfortable. They'll assist more experienced surgeons 50 or 60 times before they begin operating themselves."
The goal is to continue to provide traditional operations with excellent results, and for the right patients, to offer the advantages conferred by robotic procedures. "We'll only do it when we're confident we will get the same results as we would with our more traditional approaches," Beygui says.