Last Updated November 3rd, 2023
What is robotic-assisted heart surgery?
Robotic-assisted heart surgery is a cardiac procedure that has gained popularity in performing complex heart surgeries.
The procedure uses robotic tools with miniature cameras attached to it. Robotic tools allow the surgeon to make large incisions through your breastbone.
The robotic system allows your surgeon to have a 3-D view of the site of surgery. The surgeon controls the robot from a computer console situated a short distance from the patient.
The surgeon gets to see your interior via a high-resolution camera. Surgery is done by skillfully manipulating the control devices of this instrument situated on the edges of the robotic arms.
The robotic arms of this instrument have fingers and wrists in place similar to the human hand. This permits a high level of precision and diverse motion during surgery.
Robotic-assisted heart surgery is a less invasive procedure. It results in quicker patient recovery and reduced stay in the hospital.
Who can undergo robotic-assisted heart surgery?
Many patients are good candidates for robotic-assisted heart surgery. The procedure is particularly suitable for patients with mitral valve disease.
Other heart conditions treated using robotic surgery include:
- Coronary artery bypass
- Heart defect repair
- Removal of small cardiac tumors
- Cardiac tissue ablation
- Certain congenital heart defects
- Implanting a pacemaker
- Tricuspid valve problems
- Septal defects
If you have had previous surgery on the chest your surgeon might recommend open heart surgery in place of robotic-assisted heart surgery.
The severity and nature of your heart condition will also determine if you are a candidate for his procedure.
Your healthcare provider orders several diagnostic tests to make such a decision. They will be guided by the findings of such tests and your medical history in making this decision.
When do you need robotic heart surgery?
If your arteries get blocked due to plaque formation, you will manifest in certain signs and symptoms indicating you need surgery.
Some symptoms include:
- Having an irregular heartbeat
- Chest pain (angina)
- Periodic shortness of breath after doing small chores
Types of robotic-assisted heart surgeries
There are different types of robot-assisted heart surgeries available. The choice of a robotic cardiac surgery that is most suitable for you is mainly determined by the condition as diagnosed.
Robotic heart valve surgery
If you have valve regurgitation, you require a Tricuspid Valve or Robotic Mitral repair.
Robotic cardiac tumor procedure
Robotic surgery can be performed to remove left atrial tumors. If you have such tumors, you are at a higher risk of developing myxoma stroke.
Robotic heart bypass surgery
This is a minimally invasive heart procedure that does not require opening of your chest cavity.
The procedure is performed ‘off-pump.’ That means you do not require a heart-lung bypass machine. During an off-pump procedure, your surgeon makes several small incisions between the ribs.
The cardiac surgeon controls the robotic arms that bear surgical tools with precise movements as he/she performs the surgery.
Robotic surgery for heart implants
If the procedure requires to installation of a biventricular pacemaker or defibrillator implant, the surgeon uses the robotic arms to insert the endoscopic instruments via the small cuts in your chest cavity.
Preparing for robotic-assisted heart surgery
You would need to undergo an in-depth medical review to determine if you are fit for robotic cardiac surgery.
During such tests, your healthcare provider is interested in determining if you have had heart surgery in the past, your lifestyle, and the severity of your condition.
In addition to a complete medical history, you require undergoing a physical exam to assess your overall health and ability to withstand the surgery.
Below are some of the diagnostic tests and blood tests that your healthcare provider might order:
- Cardiac catheterization
If you are pregnant, inform about your pregnancy to your healthcare provider.
You could be advised to take aspirin before robotic-assisted cardiac surgery. If you are allergic to any medication or anesthetic agents, let your healthcare know of this beforehand.
Inform your healthcare provider of the various medications you might be taking. This includes herbal supplements and over-the-counter medication.
Patients on anticoagulants may be required to stop taking them before surgery. Smokers are advised to stop the habit before surgery.
Stopping smoking improves recovery from the procedure. It also improves your overall health.
Your healthcare provider will recommend that you fast several hours before the surgery. That means you will need to ensure you do not drink or eat anything past midnight.
Patients with a heart implant device or pacemaker are advised to let their healthcare provider know of this.
Make arrangements with your spouse, family member, or friend to drive you home once you get discharged from the hospital.
Check with your healthcare provider if they offer a health package that caters to transport to and from the hospital as well.
Your surgeon will explain the surgery to you. This is the time that you will need to ask any questions or make clarifications regarding the procedure.
You need to sign a consent form authorizing the healthcare provider to administer the surgery. Make sure you have read through the contents of your consent form before signing. If there are any parts that need to be explained or clarified, make sure this has been done.
The anesthetist will administer a sedative to help you relax prior to surgery. General anesthesia is administered.
A breathing tube is inserted into your lungs via the throat. This is then connected to a ventilator to assist with breathing.
Your surgeon might deem it necessary to connect you to a heart-lung bypass machine for the surgery. The surgeon begins by making small ports (incisions) at designated positions between your ribs.
The surgeon inserts the robotic arms inside the ports with a high level of precision. The role of robotic arms is to hold the miniature surgical instruments in place.
The robotic arms move under the control of your surgeon. For each incision, the surgeon then inserts a tiny video camera into the ports.
The miniature camera allows your surgeon to have a 3-D image of the site of operation. It does this by magnifying the operating site.
The surgeon works from the operating room and controls the robotic arm arms as needed, using a computer console.
As soon as the procedure is completed, the surgeon removes the surgical instruments. The surgeon closes the incisions.
Once the procedure is completed, you will be taken to an intensive care unit (ICU) for recuperation.
You are likely to remain in hospital for a few days. The surgical team watches you closely as you recover.
You will get discharged as soon as your surgeon has ascertained the following:
- Proper pain management
- You are not vomiting or feeling nauseated and can keep liquids down
- The results of your lab tests are near normal
Your surgeon will recommend ibuprofen and other over-the-counter medication to relieve pain.
Patients who have had robot-assisted heart surgery experience pain relief much faster than those who have undergone open heart surgery.
Ensure your incisions remain dry and clean. Avoid applying ointments or powders on the lines of the incision as it may cause skin irritation.
Applying ointment on the incision triggers the development of an infection. It may also mean that your wound takes longer to heal. Avoid soaking incisions in water.
Benefits of robotic-assisted heart surgery
There are various advantages of robotic-assisted heart surgery over conventional open-heart surgery:
- Very small incisions are needed to gain access to the heart
- Limited pain
- Faster recovery due to smaller incision
- Limited bleeding/blood loss due to smaller incisions
- Less scarring
- Reduced risk of infection
- Minimal stay in hospital (often about three or four days)
- Better quality of life
- Reduced risk for complications
Some of the potential disadvantages of robotic-assisted heart surgery are:
- The time spent during surgery is longer than what is needed in open-heart surgery
- Your surgeon might need to switch from robotic heart surgery to open heart surgery if they determine you are at risk. This rarely happens though
Only about 55 of the patients in need of mitral valve repair use robotic heart surgery switch to open heart surgery.
Other risks of robotic-assisted heart surgery are:
- Heart attack
- Reaction to the use of anesthesia
Some of the factors that might escalate your risk for robotic heart surgery include:
- Preexisting medical conditions
- Whether the surgery requires several other procedures
Talk to your healthcare provider to know of the potential risk for robot-assisted heart surgery that might be triggered by your specific medical conditions before the surgery.
Recovery after robotic-assisted heart surgery
Most people take between two and four weeks to recover from robotically-assisted heart surgery. You can resume normal daily activities like going back to work or driving.
If your surgery had complications, you might need a little longer to recover. Liaise with your healthcare provider so that you receive specific instructions on the kind of activities that you can engage in or those to avoid during your recovery.
Your healthcare provider may order regular echocardiograms based on the kind of robotic heart procedure you underwent.
Robotic-assisted heart procedure enjoys a higher success rate than other heart surgeries. When used in mitral valve repair, the procedure has a reported 99 percent rate of success.
When to call your doctor?
If you experience one or more of the following symptoms contact your healthcare provider immediately:
- Stomach upset
- Bleeding from the incision site
- Shortness of breath
- In case the incision site has a redness around it
Cost of robotic-assisted surgery in India
India offers affordable robotic cardiac surgery. The cost of robot-assisted heart surgery in India ranges between Rs. 3,50,000 and Rs. 5,80,000.
Several factors account for this cost:
The cost of robotic cardiac surgery in India will be determined by the type of healthcare provider.
Private hospitals charge more for this procedure compared to trust hospitals. In some government facilities, robotic cardiac surgery is more affordable than in trust or private hospitals.
The cost of robotic-assisted heart surgery is also determined by whether your insurance provider is paying for it.
Also, consider the type of insurance. Some health insurance providers only offer partial coverage for the surgery.
If you are having surgery at an accredited healthcare provider, you will likely get charged more.
Other healthcare facilities in India have built a reputation as the hospital of choice in robotic cardiac surgery. Since such facilities have developed a strong brand value over the years, they are likely to charge more for the surgery.
Medical team considerations
The cost of robotic-assisted heart surgery in India will be determined by the type of surgery being done.
The technology used and the type of sedation or anesthesia are also factors to consider.
The level of expertise of the surgeon along with his/her qualifications are crucial considerations. If the surgery is complex, this could mean paying more for the procedure.
The types of diagnostic tests that a patient undergoes will affect the cost of the procedure. Another consideration is the patient’s overall health.
If a patient selects a deluxe room, he/she will pay more than another patient preferring a shared room. In case of additional treatment alongside the surgery, this will also result in increased cost of surgery.
The table below provides the average cost of robot-assisted heart surgery in selected cities across India:
Why you should consider India for your robotic cardiac surgery?
India has many highly experienced and proficient surgeons who have specialized in robotic heart surgery. These surgeons are highly competent, translating to a higher success rate for your surgery.
Cardiac hospitals in India have invested heavily in cutting-edge technology to perform heart surgery. These facilities have installed the most up-to-date da Vinci technology for performing robotic-assisted cardiac surgeries.
Indian hospitals offer excellent post-surgery care with low risks for complications or infections. The cost of robotic heart surgery is extremely lower than what leading countries in Europe and the United States charge for the same procedure.
Assess the kind of services that your healthcare provider in India has to offer for international patients. Most providers arrange for on-call consultations with your surgeon.
Your healthcare provider will assist with the processing of your visa and other travel documents. They can also give recommendations for accommodation at guest houses or hotels within your budget.
You can also expect to enjoy ground transportation services including getting picked up from the airport and being dropped off when leaving for your home country.
Your healthcare provider’s executive will make constant follow-up on your health even after you have left India for your home country.
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