Mini-thoracotomy with the Da Vinci Robot

Brief video explaining use of robotic surgery for a Mini-Thoracotomy. View video with free Quicktime Player

Heart disease refers to when arteries become clogged. Over time, fats, cholesterol and other substances build up in the walls of your arteries to form a type of plaque. When some of the plaque loosens and breaks off, a blood clot forms, and blood flow to your heart is blocked. This usually results in chest discomfort called angina and a heart attack.

Coronary revascularization surgery is a heart operation that uses blood vessels to bypass clogged heart arteries. The goal of the procedure is to allow blood to flow to the heart the way it should.

More than half a million coronary revascularization operations are performed each year to fix clogged arteries. In this surgery, your doctor will take a blood vessel from your chest, let or arm. One end of the vessel is attached to a healthy artery, and the other end is attached to the diseased coronary artery below the point where it is clogged. This creates a new channel, allowing blood to flow freely again.

Figure 1: Open Chest Surgical Incision

The traditional "open" approach to coronary revascularization surgery requires that the surgeon cut through the breastbone – the body’s natural protective structure for the heart – and pull back the ribs to access the heart. This approach can prolong healing time, increase risk of infection, serious complications and even mortality.

da Vinci® Coronary Revascularization: A Less Invasive Procedure

Figure 2: Robotic Surgical Incisions

The da Vinci Surgical System made by Intuitive Surgical is currently being used for Single-Vessel Small Thoracotomies (SVST) and Multi-Vessel Small Thoracotomies (MVST). Both procedures use the da Vinci robot from start to finish, from the harvesting of the internal mammary artery, to coronary anastomosis and revascularization. Dr. Gomez performed the first Multi-vessel Mini-thoracotomy in Houston and is the leading expert in this field.

video summary of actual mini-thoracotomy

Another upside of the new technology is the ability to use stabilizers to ensure that the patient can function without use of the lung-heart machine, something that has often been cited as being more detrimental to immediate patient post-operative health than anything else. With the ability to both avoid open heart surgery and pump use, da Vinci cardio revascularization has fast become one of the most exciting cardiac surgery innovations out there. Click here for more information on off-pump bypass surgery.