AT THE FOREFRONT:
ROBOTIC CARDIAC SURGERY
THE NEWEST INNOVATION IN HEART SURGERY, AND THE SURGEON BEHIND IT
By
CORINNE STONEBRAKER SWATHI BALAJI (Editor)
In the United States, heart disease is the leading cause of death, causing approximately 1 in 4 deaths each year. While heart disease describes a range of conditions that can affect the heart, including coronary artery disease, arrhythmias, congenital heart defects, and many others, coronary artery disease (CAD) is responsible for about 60% of heart disease-related deaths. CAD can be treated with medication, or if necessary, angioplasty and stent placement, where a small mesh tube called a stent is used to open narrowed or blocked blood vessels. However, CAD often progressively worsens over time, and frequently requires coronary artery bypass graft (CABG) surgery. In fact, nearly 500,000 CABG surgeries are performed each year, making it one of the most common major operations in the nation. The conventional CABG surgery uses a mechanical saw to split and open the breastbone in order to access the heart; this approach, called a “median sternotomy,� requires an eight-inch incision down the length of the
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chest and complete fracture of the sternum. After the surgery, the fracture is wired together and a long and painful process of recovery begins. Healing of the breastbone takes at least six weeks and is fairly painful; it is the primary limitation in recovering from CABG surgery. At most hospitals across the nation, CABG surgery is performed in this conventional manner with long and painful recovery ahead. However, at UChicago Medicine, patients leave the hospital less than 48 hours after CABG surgery, with minimal pain and no more than three to four eight-millimeter incisions. This incredible feat is made by possible by a handful of skilled surgeons and a powerful robotic surgical system. Originally, the Da Vinci Robotic Surgical System was created for the United States military in the 1990s as a way for surgeons to treat fallen soldiers in the field without being exposed to the frontline. Although it did not come to fruition in military use, the da Vinci robot was soon appropriated for clinical use. The first specialists to
adapt the technology widely were urologists, for use in minimally invasive robotic prostate surgery. Only in the past ten years has minimally invasive robotic surgery pervaded other specialties, including thoracic surgery, gynecological surgery, and cardiac surgery. In August, UChicago Medicine completed its 10,000th robotic surgery across all specialties. At other centers, robotic cardiac surgery is used is used mainly for a few specific procedures, like valve repair, but very few have embraced robotics in the majority of procedures the same way UChicago Medicine has. I had the opportunity to sit down with Dr. Husam Balkhy, the Director of Minimally Invasive and Robotic Cardiac Surgery at UChicago Medicine, a pioneer in the field of minimally invasive and robotic cardiac surgery, and the only surgeon in the world with extensive experience performing multiple vessel CABG surgery with a robotic surgical system and innovative anastomotic devices. This surgery, known as robotic totally endoscopic beating heart
