Innovation for Boomers
by Connie McMullen
Physicians are finding open heart surgery less invasive, and recovery time quicker for patients who undergo valve repair with new robotic technology introduced to northern Nevadans this year.
A procedure sure to attract baby boomers because of the life saving benefits that are cosmetically more appealing, the da Vinci® S HD™ Robotic Surgical System has opened a whole new perspective to heart surgery, advancing procedures powered by state-of-the-art robotic technology.
The innovative surgery relies on the expertise of Renown Health's, Dr. Athan Roumanas, M.D., a Board Certified cardiac surgeon with Nevada Heart Surgeons, and the director of cardiac surgery at Renown Regional Medical Center. Dr. Roumanas successfully completed his first da Vinci® Mitral Valve Repair in May, and has performed several procedures since. Using the da Vinci® S HD™ Robotic Surgical System, Dr. Roumanas takes “Open” out of the phrase “Open-Heart Surgery.
Using the robotic system, Dr. Roumanas and his colleagues make three dime-sized and one five-centimeter-sized incisions in the side of the chest, through which they insert three robotic arms. One arm holds a tiny camera, which projects three-dimensional images onto a monitor in front of the surgeon. The other two arms hold the pencil-sized instruments, which have tiny computerized mechanical "wrists" designed to transmit the dexterity of the surgeon's forearm and wrist into the operative site. Seated at a computer console located approximately ten feet away from the operating table, the surgeon views a magnified, three-dimensional image and manipulates the surgical instruments using two fingertip controls.
“The operation is challenging for the surgeon because it is very difficult to operate through such small holes,” Dr. Roumanas said, adding, “the operation is also stressful for the patient because it is tedious.” The day of the interview for Generation Boomer, Dr. Roumanas began a valve repair operation to close a hole in a patients heart at 9 a.m., but did not finish the procedure until 4:20 p.m. that day.
“The procedure is technically challenging,” he said. “You have to have good hand to eye coordination to work from a distance.”
Clinical supervisor, Rick Williams, da Vinci coordinator, explains, “The benefit is that the surgeon doesn't have to split the sternum, and open the rib cage. The robotic tool makes small incisions to access the heart, but does not split the chest.”
Williams says all the physicians using the da Vinci are trained at hospitals already using the system. “Even though the procedure is Laparoscopic surgery, the benefit is a 3-D view. The advantages are that the robot has trimmers; there is no hand shake.”
For the patient the benefits are tremendous. In addition to avoiding the pain and trauma of sternotomy and rib spreading, da Vinci® Mitral Valve Repair provides most patients with less risk of infection, less blood loss and need for blood transfusions, shorter hospital stay, significantly less pain and scarring, faster recovery, quicker return to normal activities and a potentially better clinical outcome.
Dr. Roumanas poses in surgery center
“The procedure also helps avoid mitral valve replacement where the natural valve tissues are cut away and replaced with an artificial valve,” explained Dan Davis, Renown spokesman. “This is important because a repair can provide the patient with many significant advantages that include no need to take life-long blood thinners, less need for additional operations, reduced risk of surgical complications, a higher longterm survival rate and improved heart function. Recent studies also suggest that the da Vinci System may allow surgeons to complete 50 percent more repairs than they can using an open surgical approach.
Since acquiring the da Vinci early this year, Renown surgeons have performed 38 procedures including hysterectomies, prostatectomies as well as the more recent heart valve procedures.