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What is robotic valve repair?

Robotic valve repair surgery is a minimally invasive alternative to traditional open heart surgery. Instead of one large incision, your surgeon will operate through a few tiny ones—allowing for faster recovery with less pain, scarring and blood loss than regular surgery. Robot-assisted surgery may also be an option if you’re not a candidate for traditional surgery.

Why it's done

Robot-assisted surgery gives your doctor better vision and enhanced skills in the operating room. During the procedure, your surgeon remains in complete control and uses highly flexible 3D cameras that provide a high definition view. This view far exceeds what’s visible to the human eye during traditional surgery.

These robotic instruments provide a range of motion and level of precision that the human hand cannot, so your surgeon can manipulate delicate tools to access hard-to-reach areas of your body with improved accuracy. 

Additional benefits of minimally invasive robotic surgery:

  • Increased valve repair rates
  • A lower risk of infection
  • Improved recovery times
  • Earlier return to normal activities

Several methods of surgery are available:

  • Minimally invasive mitral valve repair – Our Center offers patients with mitral valve prolapse the possibility of a less invasive operation. The operation is performed through a three-inch incision between the ribs on the right side of the chest. Valve repair or replacement surgery is used to repair the flaps (“leaflets”) of the valve if they do not open up wide enough to allow sufficient blood flow through the valve into the artery. If the leaflets do not close tightly, blood can leak back into the heart’s chambers.
  • Transcatheter aortic valve replacement surgery (TAVR) – When the heart’s aortic valve becomes narrower than normal and impedes the flow of blood, the condition is known as aortic valve stenosis or aortic stenosis, and can cause life-threatening impairment of heart function. In cases of severe aortic stenosis the valve must be replaced, which has traditionally required open-chest surgery. Unfortunately, this surgery is often considered too risky for many patients, especially older ones.
    TAVR is a minimally invasive treatment alternative to traditional open-chest surgery. This breakthrough procedure, performed through an incision between the ribs to avoid splitting the breastbone, provides a potential lifeline for the highest-risk patients with severe aortic valve stenosis and can result in both longer life and better quality of life. For patients who require aortic valve replacements and are considered good candidates, minimally invasive techniques include partial sternotomy.
    During the transcatheter aortic valve replacement procedure, the cardiac surgeon inserts a replacement aortic valve in the area of the patient's own aortic valve, through a small puncture in the femoral artery of the leg or through a small incision in the side of the chest.
  • Robotic heart surgery – The Minimally Invasive and Robotic Heart Valve Surgery Center is the first center on Long Island to use the Da Vinci® surgical robot. This system includes small instruments which are inserted between the patient’s ribs without splitting any bones. The miniature instruments are guided by and replicate the surgeon’s hand motion through information from a console in the operating room. A monitor enables the surgeon to see the instruments and adjust movements accordingly. This technology has enabled some cardiac procedures to be performed less invasively without sternotomy.

Our approach

At Northwell Health, we’re raising the bar for surgical precision. That's why we were recognized as the first Robotic Surgery Network of Excellence in the nation by the Surgical Review Corporation. We are one of few care teams in the nation with the latest in minimally invasive heart treatments for all heart valves, and see some of the largest volumes of patients in New York State. Because of our expertise, our physicians are selected by medical device companies to teach new surgical techniques at hospitals around the world.

Your cardiac surgeon will review the results of your medical history and your current condition to determine whether you are a candidate for minimally invasive robotic valve repair surgery. During this process, our team will carefully compare the advantages and disadvantages of minimally invasive techniques versus traditional surgical techniques.

Success statistics

Our cardiac services have been consistently recognized by the New York State Department of Health and the Society of Thoracic Surgeons for excellent patient care and outcomes. That means you can rest assured that you-–and your heart-–are in good hands.

Risk factors

As with any surgery or procedure, possible risks are involved in robotic surgery. These risks may be related to certain factors such as your age and current medical conditions. Speak with your cardiologist to discuss any possible risks and/or complications.

What to expect

The following is the typical order of events that will most likely occur during robotic valve repair:

  • You will be placed under general anesthesia for the surgical procedure and a breathing tube will be placed.
  • Your surgeon will make a series of keyhole-sized incisions on the side of your chest. The incisions will align with the openings between your ribs.
  • Depending on the procedure being performed, several precision-guided robotic arms will be inserted into the incisions.
  • The robotic arms hold and manipulate tiny instruments in order to perform the required tasks on the heart valves. 
  • A tiny video camera will be inserted into another incision to provide a magnified, 3D image of the operating site.
  • Your surgeon will control the robotic arms and camera from a special console located within the operating room.
  • On completion of surgery, your surgeon will remove the instruments and close the incisions.

Recovery

Once the robotic surgery is complete, you will be moved to the recovery area to be monitored. You can expect a relatively short hospital stay to follow, usually half as long as following conventional open heart surgery. Your doctors will typically discharge you once your pain is under control, you can retain liquids without nausea and vomiting and you pass a number of lab tests.

The following are some of the postsurgical benefits of minimally invasive robotic procedures: 

  • The less invasive nature of robotic cardiac surgery means that you can expect less scarring on your chest. Conventional heart surgery scars can be up to 10 inches; scars from robotic cardiac surgery are usually much smaller.
  • Postsurgical pain also tends to go away much faster than with traditional procedures. After being discharged from the hospital, most patients can manage their pain with over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
  • You may also return to normal activities more quickly than you would after conventional heart surgery. Most people can resume their normal activities after three weeks. Specific recommendations for activity will be provided by your doctor.

Be sure to notify your doctor immediately if any symptoms occur after the procedure, such as chest pain or discomfort. After robotic valve surgery, complications are rare but possible, so it is important to carefully monitor for any symptoms and report them to your doctor.

Results

Our cardiac services have been consistently recognized by the New York State Department of Health and the Society of Thoracic Surgeons for excellent patient care and outcomes. That means you can rest assured that you-–and your heart-–are in good hands. 

Follow-up care

During the first few months after surgery, follow-up visits and post-surgical testing at your doctor’s office is strongly encouraged. While medications and surgery will treat heart valve disease, they will not fully cure it. You will always need to see your doctor for lifelong follow-ups to make sure your heart valve functions as it should.

Life after surgery

How you feel after surgery will depend on your overall health, how the surgery went and how well you take care of yourself. It's important to maintain your heart health after surgery by making positive lifestyle changes. This may include:

  • Quitting smoking
  • Treating high cholesterol
  • Managing high blood pressure and diabetes
  • Exercising regularly
  • Maintaining a healthy weight
  • Eating a heart-healthy diet
  • Participating in a cardiac rehabilitation
    program, as recommended
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