Port Placement And Docking
The surgeon makes several small incisions or ports between the ribs usually eight to twelve millimeters wide. The robotic camera and instrument arms are inserted through these ports. The Da Vinci Robotic Surgery System cart is then driven up to the operating table and docked or attached to these ports. The surgeon then scrubs out and sits at the control console while a surgical assistant stands by the patient to change instruments and assist with suction or clip application.
Performing The Surgery With Da Vinci Robotic Surgery System
The surgeon performs the operation by manipulating the master controls at the console. The Da Vinci Robotic Surgery System translates these movements into precise actions inside the heart. For valve repair the surgeon cuts out diseased tissue and sutures the valve ring in place. For bypass they sew the graft vessel to the coronary artery. The 3D high definition vision allows for identification of vital structures. Small blood vessels are sealed instantly to prevent bleeding. The precision is unmatched by human hands alone.
Cardiopulmonary Bypass Management
For many robotic heart surgeries the heart must be stopped to allow for precise suturing. A heart lung machine takes over the job of pumping blood and oxygenating it. This is connected via tubes placed through small incisions in the groin vessels rather than the large chest opening. This technique is called peripheral cannulation. The perfusionist manages the machine while the surgeon operates. Once the repair is complete the heart is restarted and the machine is disconnected.
Specimen Removal And Closure
If any tissue such as a tumor or part of a valve needs to be removed it is placed inside a retrieval bag within the chest and pulled out through one of the port sites. The robotic arms are undocked and drainage tubes are placed to remove fluid and air from around the heart. The small incisions are closed with dissolvable sutures or surgical glue. The anesthesia team then wakes the patient up and ensures they are stable before transport.
The Recovery Room Experience
The patient is transferred to the Intensive Care Unit or ICU. Here specialized nurses monitor vital signs oxygen levels and heart rhythm continuously. It is normal to feel groggy. Pain is managed with IV medication and often a nerve block placed during surgery to numb the chest wall. Most patients spend about twenty four hours in the ICU before moving to a regular hospital room or step down unit depending on their progress.
Pain Management And Mobilization
Pain after robotic surgery is generally manageable and significantly less than open surgery because the breastbone remains intact. Most patients utilize a multimodal pain control strategy including oral medications. The nursing team encourages early mobilization. Patients are helped to sit in a chair and walk in the hallway often on the day after surgery. Walking is crucial to expand the lungs prevent pneumonia and speed up the return of bowel function.
Discharge From Hospital
The hospital stay for robotic surgery is short relative to open heart surgery. Most patients go home within three to five days. Discharge criteria include controlled pain ability to walk normal vital signs and stable heart rhythm. Patients receive a discharge summary with instructions on wound care breathing exercises and when to call the doctor. The quicker return to home allows patients to recover in a comfortable environment.