Heart surgery: here come the robots!

Cirurgia cardíaca: eis os robôs!

Robotic heart surgery is already a reality and brings clear benefits in terms of safety, reliability, recovery time and the possibility of faster recovery for patients. But it does not make surgeons better.

The symposium “Robotic Cardiac Surgery – The future now” sought to do justice to the congress name – Leaping Forward – and showed that robotic heart surgery is already an established reality in clinical practice, but it generates discussion between those who see its obvious advantages and those who continue to be sceptical of its possibilities. Because of this, it was a lively session, with many questions and answers between speakers and the audience. As a backdrop, the symposium included a live robotic heart surgery performed by the director of the symposium, surgeon Ricardo Arruda Pereira, assisted by the Belgian Jean Luc Janssens, surgeon and associate professor of heart surgery at Erasmus Hospital, of the Free University of Brussels.

The procedure carried out by the surgical team was a robotic heart revascularisation on a 50-year old female patient with heart disease. The technique, designated “TECABG” (Totally endoscopic coronary bypass graff), was the first done at Hospital da Luz with the Da Vinci Si HD robotic surgery system.

Louis Labrousse, professor at the University Hospital of Bordeaux, stated that, first of all, his institution developed a protocol for multidisciplinary integration between the heart surgery and heart electrophysiology team for a robotic approach to the procedures done at that hospital.

“Robotics is used at our practice when there are technical limits to the conventional approach”, said Louis Labrousse, citing its simplicity, reliability, and safety, including in illnesses with heart failure.

The Belgian Jean Luc Jassens spoke about the state-of-art robotic heart revascularisation, emphasising that heart surgeons like himself try to be less invasive than they were before and believes that dual console robotic technology will bring advantages to the performing of procedures.

In his presentation, North-American Wiley Nifong, associate professor and director of robotic surgery at the East Carolina Heart Institute, spoke about mitral valve robotic surgery and stated that robotics is merely a tool that helps surgeons to do procedures in a slightly different way: “but it does not make us better surgeons”, he said, adding that even if on the exterior the robotic surgical system allows for less invasiveness, inside the heart it is still a major intervention.

Finally, and given his vast experience in heart robotic surgery, he had no qualms about asserting that robotics brought some advantages to the resolution of more complicated cases, but recognised that there is still a need for more thorough research to identify a clearer advantage.