Surgeons use da Vinci surgical robot to perform common cardiac surgery

Surgeons at El Camino Health Heart and Vascular Institute prepare for surgery. | Source: El Camino Health Heart and Vascular Institute

Coronary artery bypass grafting, or CABG, is the most common type of cardiac surgery in the world. Despite this, and the heavily invasive nature of the surgery, only 1% of these procedures are performed with the help of robots.

At the El Camino Health Heart and Vascular Institute (HVI), surgeons are now performing CABG with Intuitive Surgical ‘s da Vinci robotic system. The first procedure was performed by Dr. Nels Carroll, who has extensive experience in robotic cardiac techniques and one of only a few surgeons in the Bay Area offering this robotic-assisted bypass capability.

“Think of the heart as the engine that’s pumping the blood and delivering energy and oxygen to the body. Basically, that engine has its own fuel lines, those are the arteries on the surface of the heart,” Carroll told The Robot Report . “They’re providing the fuel to keep that engine pumping, and it’s very common for people to develop disease in those fuel lines. Bypass surgery is just us putting on new fuel lines.”

The cardiac surgery itself is straightforward, he noted. The tricky part is reaching the heart in the first place.

“The most challenging thing for the patient is that, historically, we have to cut their chest open,” said Carroll. “We have to divide the sternum and spread it to the side.”

“Doing the same thing robotically means that instead of making that big incision and instead of cutting that bone and opening all that space, we just put little incisions between the ribs,” he continued. “We don’t cut any bone, and we don’t cut any major muscle groups.”

The robotic instruments and cameras can fit inside the small incisions, which allows cardiac surgeons to perform the same procedure.

The most common approach to a CABG involves the surgeon opening the chest by dividing the breastbone to reach the heart. | Source: El Camino Health Heart and Vascular Institute

The biggest benefit of robotic surgery for cardiac bypass patients is in the recovery time, according to Carroll.

“It’s so much easier to recover from small incisions between the ribs than it is from a conventional surgery, where the bone is put back together with stainless steel wires,” he said. “The big difference is how quickly people get back to their daily lives, how much less pain they encounter, and how much less traumatic the experience is for them overall.”