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UCLA Department of Surgery

UCLA Department of Surgery

Robotic and MIS Cardiac Surgery

Minimally Invasive & Robotic Heart Surgery

At the UCLA Division of Cardiothoracic Surgery, surgeons are operating on the hearts of adults and children through tiny openings in the chest, eliminating the need for sternotomy--a large incision through the breastbone (sternum). This method of surgery, called minimally invasive cardiac surgery, offers many benefits compared to traditional, open-chest procedures. Surgeons use sophisticated thin instruments, miniature cameras, robotic devices, and hybrid techniques with coronary stenting to perform the operations.

Benefits of Minimally Invasive Heart Surgery

Minimally invasive heart surgery offers several advantages compared to open-chest procedures, including:

  • Faster return to normal activities. Rather than waiting several weeks to heal, patients can return to work or other activities much more quickly--usually within three weeks.
  • Shorter hospital stay. Time spent in the hospital can sometimes be reduced by as much at 50 percent, compared to open procedures.
  • No splitting of the breastbone. Keeping the breastbone (sternum) intact reduces the chance for post-surgical complications and infection.
  • Smaller incisions. Depending upon the case, the operation may be performed through four to five dime-size incisions, or through a 2- to 5-inch incision at the side of the chest. Traditional open-heart procedures require a longer incision down the center of the chest.
  • Quicker resolution of pain. Decreased damage to tissue and muscle results in pain that does not last as long as after a sternal incision. Tylenol or aspirin are often enough to manage pain after hospital discharge.
  • Elimination of the heart-lung bypass machine, in most cases. Avoiding the bypass machine decreases the risks for neurological complications and stroke.
  • Minimal blood loss and less need for transfusion.
  • Little scarring. Instead of a long chest scar, only a few tiny scars or a short, 2- to 5-inch scar remains.

Full Spectrum of Minimally Invasive Procedures

We're one of a handful of hospitals in the world that offers a wide range of minimally invasive procedures for heart conditions. Every member of our cardiac surgery team has specialized expertise in minimally invasive cardiac surgery.

Some of the minimally invasive procedures regularly performed by UCLA Division of Cardiothoracic Surgery surgeons include the following:

  • Single and multiple vessel coronary artery bypass surgery, to improve blood flow to the heart and to reduce chest pain.
  • Valve repair and replacement, to restore proper valve function
  • Surgery to correct atrial fibrillation, a common type of arrhythmia
  • Implantation of ventricular heart devices to boost the pumping action of the heart in heart failure patients

It's not uncommon for our surgeons to correct more than one heart problem during a minimally invasive procedure. For example, a person who needs mitral valve repair and bypass surgery can have both problems treated during the same operation without opening the chest.

  • View a list of minimally invasive procedures for adults
  • Learn more about minimally invasive procedures for children

Robotic Device Improves Precision

Some minimally invasive heart surgeries performed at UCLA Division of Cardiothoracic Surgery are done with the help of a special robotic device, called the da Vinci Surgical System. The da Vinci robot is a highly sophisticated tool that enables the surgeon to perform the procedure with greater precision and control than is possible in traditional hands-on surgery. In robotically assisted surgeries, the chest cavity is accessed through dime-size "keyhole" incisions.

Robotic cardiac surgery procedure. The surgeon is seated to the left at the da Vinci console, where he controls the system's robotic arms to perform the surgery. The robotic arms are shown at right, directly above the patient.

The surgeon sits in a console equipped with controls that direct robotic arms to perform the surgery. The da Vinci's robotic arms are essentially an extension of the surgeon's hands. A tiny camera attached to a robotic arm gives the surgeon a very detailed, three-dimensional view of the operating space inside the chest. The robotic arms are very agile, providing the surgeon a greater range of motion than is possible with hand-manipulated moves in standard procedures.

Experience and Excellence Count

Experience is important for all types of surgery, but the right experience is essential for minimally invasive and robotic surgery. There is a steep learning curve associated with minimally invasive surgery, because it's very different than operating through a large chest incision. Even otherwise highly experienced surgeons must devote dozens of hours to learning how to use the techniques and equipment for minimally invasive surgery. After learning how to use these tools, the surgeon must regularly perform minimally invasive surgery to truly master the approach. Volume counts. There is a great deal of difference between a surgeon who has performed 15 minimally invasive procedures versus a surgeon who has done hundreds of hundreds of cases.

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