ROBOTIC SURGERY

What is it
Traditionally open heart surgery requires surgeons to make an 8 to 10 inch incision, saw through the sternum and retract the rib cage to gain access to the heart. Minimally invasive surgery was the first step in revolutionizing cardiac procedure. Most minimally invasive surgery is performed by passing an endoscope (a small tube carrying advanced optical system) through a tiny incision. Such endoscopic surgery works well for several types of operations (such as gall bladder removal and knee repairs) where part of the body to be operated upon motionless and surgical maneuvers to be performed are relatively simple. Thus endoscopic surgery has achieved only limited success in more complicated operations such as heart surgery, where the heart is beating and the necessary surgical maneuvers are complex.

Robotically-assisted heart surgery is the latest advance in trying to more open heart surgical procedures to the category of minimally invasive surgery. With this technology the surgeon manipulates the surgical instruments with the help of a computer. It is much more adaptable than keyhole surgery, which often restricts the surgeons hand movements. Computer control of the surgical instruments essentially eliminates the tremor effect. The surgeon controls the robot from a distance. He does not even need to be in the same room. He could even by thousand of miles away. Instead of manipulating the surgical instruments directly, be manipulates them through a computer which causes the surgical instruments to respond accordingly.

Chief advantage of such surgery is that a high degree of precision is achieved, the incisions are tiny and therefore, recovery from surgery is extremely quick.

Robotic procedures have been successfully performed in Escorts Heart Institute And Research Centre, for instance, in coronary artery bypass grafting (CABG), mitral valve repair and replacement and atrial septal defect (ASD) closure.

Robotic system AESOP (Automated Endoscopic System for Optimal Positioning) is being used since last three years at Escorts Heart Institute to assist the minimally invasive heart surgery. AESOP is electronically programmed to instaneously respond. To surgeon's notice and when the surgeon wants to peer into hearts interior during an intricate mitral valve operation, be used clipped commands to instruct the robot to change positions. Video images from the robotic endoscope provide bird's eye view of the patient's mitral valve. AESOP's video-assisted mitral valve surgery take minimally invasive mitral valve operations to a new level. We at Escorts Heart Institute already performed more than 600 heart operations with the help of AESOP robotic system. Those operations include mitral valve repair and replacement, triscuspid valve repair and replacement , atrial septa, defect closure and internal mammary artery harvesting for coronary artery bypass surgery. For mitral valve, tricuspid valve and atrial septal closure surgery close chest minimally invasive cardio pulmonary bypass system (port access system) is being used. Escorts Heart Institute is the only centre in India which is using port access system for mitral vale and tricuspid valve surgery and atrial septal defect closure.