When it comes to heart health, Dr. Deon Vigilance is a legitimate trailblazer. Chief of cardiothoracic surgery at Mercy Fitzgerald Hospital, Vigilance has embraced the state-of-the-art da Vinci Xi robotics system. It translates his hand movements in real time, bending and rotating the instruments during the procedure. The system allows him to perform less-invasive surgeries that lead to easier and faster recoveries for his patients.
Frank Tancredi is one of them. He was 55 when he had his first heart attack, which required a stent. Almost a quarter century later, another blockage was discovered, and Tancredi underwent a minimally invasive robotic-assisted beating-heart bypass surgery in May 2021. At one time, the sternum (or breastbone) was cracked for such a procedure.
Dr. Vigilance did his work via a small incision between the ribs.
At first look, the idea of surgery involving anyone other than a skilled pracitioner seems offputting—let alone any complex procedure performed by a robot. Dr. Vigilance assures patients that it’s the surgeon controlling things every step of the way. The tiny-wristed instruments move like a human hand, only with a greater range of motion. The da Vinci system also delivers highly magnified, high-definition 3-D views of the surgical area. And the instrument size makes it possible for surgeons to operate through one or just a few small incisions. “The robot does nothing unless I instruct it to do so,” says Vigilance. “I actually move the arms of the robot—it can’t do anything on its own.”
Dr. Gwo-Chin Lee is certainly sold. “Robotics will help evolve the way we perform hip and knee replacements as we use it and acquire vast amounts of patient data from each procedure,” says Lee, an orthopaedic surgeon at Penn Medicine and a professor of orthopaedic surgery at Perelman School of Medicine.
Lee notes that data analysis from such surgeries helps him learn the best alignment, positioning and balance for hip and knee implants. “Patients are increasingly asking for and seeking out robotic solutions for hip and knee arthritis,” Lee says. “The primary advantage of robotics in joint replacements is the amount of real-time information available at the time of surgery.”
That enables surgeons to proactively plan their procedures and individualize care. “In cases with altered anatomy and deformity, there are distinct advantages over conventional manual instrumentation,” says Lee. “Androbotics improves consistency and accuracy in procedures that are less routinely performed in some practices.”
As for Tancredi, he couldn’t be happier. With the help of visiting nurses and physical and occupational therapists, he’s been able to get back to regular activities with his family. He was driving in less than a month—half the time required after more invasive heart surgeries. “After I’m finished with rehab, I’ll join a gym and go a few times a week,” Tancredi says.
The way Vigilance sees it, robotics is nothing less than a game-changer, especially with the increased need for more minimally invasive surgical procedures for coronary artery and heart valve disease. Going forward, he predicts that a lot more minimally invasive operations will be offered to patients.
“As an instrument, the robot is now being implemented to facilitate visualization and dexterity,” he says.
And that’s some vision of the future.