A minimally invasive cardiac surgery, with robotic assistance

Procedure does away with need for splitting the chest bone

February 23, 2019 01:03 am | Updated 01:41 am IST - CHENNAI

Quick recovery:  J. Malliga after her surgery at Apollo Hospitals .

Quick recovery: J. Malliga after her surgery at Apollo Hospitals .

Doctors at Apollo Hospitals performed a minimally invasive robotic hybrid revascularisation surgery to treat blockages in two major blood vessels of a 63-year-old patient.

The procedure was a combination of minimally invasive coronary artery bypass grafting (CABG) surgery with robotic assistance, followed by a stenting procedure. This, according to M.M. Yusuf, cardiothoracic surgeon, Apollo Hospitals, did away with the need for splitting the chest bone. J. Malliga, a diabetic, was brought to the hospital on February 18 with chest pain. Doctors found that she had blocks in two of the three major blood vessels.

Dr. Yusuf performed the minimally invasive CABG using a robot under the guidance of Frank Van Praet, director of Robotic and Minimally Invasive Cardiac Surgery, OLV Hospital, Belgium. This allowed the surgeon to work on a beating heart through a small chest incision without having to split the chest bone.

Explaining that the CABG was done with LIMA (left internal mammary artery) to LAD (left anterior descending artery), he said, “In this, the artery from the left side of the chest bone was taken and used to bypass the blockage in the main artery supplying blood to the left side of the heart,” he explained.

The patient is ready to go home in 48 to 72 hours and can resume normal activities in two weeks, he said. “The advantages are negligible pain, hardly any blood loss, shorter hospital stay, accelerated recovery time and good long-term results,” he told reporters on Friday.

Diabetics have long multiple blockages with small calibre arteries. So, LIMA to LAD is preferred in diabetics, whereas drug eluting stents are better in non-LAD blockages, added K. Damodharan, senior consultant, Cardiology, Apollo Hospitals. “Any diabetic with multiple blocks can choose this hybrid modality of revascularisation. Here, a small hole, hardly three inches, was cut,” he said. After the minimally invasive surgery, stenting for the non-LAD vessels was done.

Doctors said this was the country’s first minimally invasive robotic hybrid revascularisation surgery to be performed. Dr. Praet said they had set up a training programme at OLS Hospital, Belgium, and hoped to train surgeons here in minimally invasive procedures.

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