The world is looking forward with the advancement in technology. Robotic heart surgery is another surprise for us. Although Robot Guided Heart surgery is not new but it is still in her childhood.

Robotic heart surgery: A brief history
The world's first robotic CABG in the world was performed in Leipzig Heart Centre, Germany in May 1998 by Professor Friedrich-Wilhelm Mohr and his team. German surgeons have performed around 300 CABG using the robot technology.

Dr W Douglas Boyd, cardiovascular and thoracic surgeons at London Health Science Centre, Ontario, Canada conducted the world's first closed chest robot assisted beating heart CABG in 1999. At present, this technique is used for single vessel CAD but it is hoped that in near future it can be used for double and triple vessel bypasses.

Where applicable?
Apart from CABG, this technique is used for mitral valve operation, closure of heart defects, treatment of heart failure, and treatment of heart rhythm (irregular heart beat) problem.

Robotic heart surgery is suitable for correction of congenital heart diseases. In children this technology is used for ligation of Patient Ductus Arteriosus, repair of coarctation of aorta, mitral and tricuspid valvoplasty. This technology is not only confined in to heart surgery, it is used in thoracic, abdominal, pelvic and neuro-surgery as well.

Benefit of robot assisted surgery
Heart surgery is a major surgery. There has been a very big effort towards performing heart surgery in a less invasive manner. The goal of robot assisted heart surgery is for better out come, early recovery, less pain, less hospital stay, back to work faster, less trauma, back to regular activities sooner.

In traditional heart surgeries, the surgery starts with making a long (about a foot long) incision in the mid line of the chest and sawing through the breast bone. Then chest in opened and large tubes are inserted in the major vessels and/or chambers of the heart to connect with the heart lung (cardio-pulmonary bypass) machine. The patients are systemically cooled down and the heart stopped completely, which gives 'still' field to work on heart. After the surgery, patient is re-warmed systemically, the heart started beating and tubes are removed. The chest is closed with stainless steel wires.

Robot assisted surgery allows cardiac surgeons to perform surgery through very small incisions. There are three tiny incisions are made within the spaces between the ribs of the chest. The robotic arms and a tiny camera are placed through these holes. Motion sensors are attached to the robotic 'writs' so the cardiac surgeon can control the movements. Instruments are then attached to the robotic arms.

The advantages of the robotic surgery compare to conventional surgery are less trauma, less pain, use of less pain medicine, less bleeding, less infection, shorter hospital stay, minimal scarring, quicker return to normal life.

Where performed now-a-days?
Surgeons from New York Presbyterian Hospital (recently former US President Bill Clinton had heart surgery in this hospital) performed robot assisted repair of heart defects (Atrial septal defect). Of the 17 patients ,16 of them had their heart repaired in a totally robotic operation.

There are approximately 132 centres worldwide, over 100 centres in the USA alone.

Disadvantages
Although the robot assisted heart surgery looks promising, it has disadvantages as well. It takes longer operating time compare to conventional surgery. The cost of a robot is over one million US dollars and maintenance cost is about 100,000 US dollars per year.

Robot assisted heart surgery is not for everybody. At present, about 10 per cent of the heart surgery patients will get benefits form this procedure. The development of this system for use in the heart is a step forward in new robotic technology that eventually could change the practice of heart surgery.