Robotic surgery is growing in popularity. But don’t worry, we aren’t replacing surgeons with machines. Rather, robots help surgeons operate more precisely and in smaller spaces. Incisions can be smaller, which lowers the risk of complications and speeds up healing.

Robotic technology has advanced to the point where heart surgeons now recommend it for mitral valve repair and coronary artery bypass surgery. 

“Almost anyone can be a candidate for robotic heart surgery, except for very sick patients or those who’ve had prior surgery on their chest,” says Arnar Geirsson, MD, chief of cardiac surgery at Yale Medicine and associate professor of surgery at Yale School of Medicine. 

In some cases, a traditional open surgical approach is better. If you know that you’ll need heart surgery, discuss the pros and cons of robotic versus traditional surgery with your doctor.

One benefit for patients who come to Yale Medicine is that our surgeons operate with the da Vinci Xi Surgical System, the latest model offered by a leading robotic surgery brand.

Robotic surgery is different than a traditional surgery in that the cardiac surgeon is not standing over the patient. Instead, the surgeon sits at a computer console that shows a high-definition video of the interior of the patient’s body as seen through an endoscope-mounted camera. Performing surgery involves gently gripping and manipulating devices that control surgical instruments located at the end of the robotic arms. 

The robot mimics the movements made by the surgeon’s hands in a way that is extremely precise and better than what a human could achieve. Software programming compensates for any tremors in the surgeon’s grip.

At Yale Medicine, robotic surgery is primarily used for patients who need mitral valve repair and coronary artery bypass surgery. However, the da Vinci Xi Surgical System can be used for other heart-related surgery. Your surgeon may use it for one of the following procedures:

• Mitral valve repair and replacement surgery
• Tricuspid valve repair and replacement surgery
• Combined mitral and tricuspid valve surgery
• Ablation of atrial fibrillation
• Atrial septal defect repair
• Patent foramen ovale repair
• Removal of cardiac tumors

One significant advantage is that robotic access to the heart can be gained via very small incisions on the sides of the chest. This is far less traumatic for patients than the much larger incision across the front of the chest that is required by traditional heart surgery, so there is a lower risk for complications and, typically, faster recovery. 

Smaller incisions usually mean that less blood is lost during the procedure. As a result, the need for blood transfusions decreases or even goes away completely. Other advantages include shorter hospital stays due to a faster overall recovery and less pain.

“Usually the smaller incision is less painful for the patient,” Dr. Geirsson says. “There is no splitting of the breastbone, patients return to normal function and work faster, and have higher level of satisfaction.”

Yale New Haven Hospital is currently the only hospital in New England that offers robotic mitral valve repair. Dr. Geirsson has been a pioneer in the field of minimally invasive cardiac surgery. He was the first surgeon at Yale to perform minimally invasive mitral surgery through a small incision in the right chest and now with the use of the da Vinci Xi robot. Yale is a high volume mitral valve program with excellent repair rates and results that surpass national figures.

In addition, patients who are evaluated for cardiac surgery at Yale Medicine are cared for by a multidisciplinary heart team that includes both cardiologists and cardiac surgeons. “The heart team was developed to make sure that each patient gets the optimal treatment for their condition, regardless of what type of procedure needs to be performed,” Dr. Geirsson says.

Yale Medicine's heart team is unique in Connecticut, although the heart team concept is used in major medical centers throughout the United States.