Robotic Surgery: Good News for Hearts

Organization: Service: Story Topics:
Robotic Assisted Surgery, Heart Disease
Annie Capaldi

Annie Capaldi, a high school athlete, had never heard of robotic-assisted surgery.

But during a routine exam in the spring of 2009, Scott Newman, M.D., a physician with Memorial Prompt Care and Family Medicine, discovered a heart problem that threatened to put the 15-year-old's athletic career on hold. An athlete from an early age, Annie played her first soccer game at age 4, joined a competitive team when she was 9 and continued competing at an advanced level well into high school.

Tests confirmed that the young Corona del Mar resident had an atrial septal defect or ASD—a hole in the wall between the upper chambers of her heart.

"I was shocked because I'd always been so healthy and active," says Annie.

A Robotic Solution

"The heart has four chambers—two lower ventricles and two upper chambers known as the atria. The atria are separated by a wall called the septum. An ASD occurs when part of the septum doesn't develop properly before birth," explains Daniel Bethencourt, M.D., a leading cardiothoracic surgeon and medical director of cardiac surgery at the MemorialCare Heart and Vascular Institute (MHVI).

This defect allows oxygen-rich blood to leak from the left to the right atrium. From there, it flows to the lungs instead of circulating throughout the body. In some cases, the extra blood can strain both the heart and lungs.

Most people with an ASD have no symptoms and appear healthy. But if the hole isn't repaired, serious problems can develop. These include an enlarged heart, increased risk of stroke and pulmonary hypertension— high blood pressure in the lungs.

An ASD can be treated two ways. A long tube called a catheter can be used to implant a special device that seals the damaged area. The catheter is threaded through a blood vessel in the groin, avoiding the need for major surgery.

The other option is surgical repair. This normally requires making a long incision in the chest and separating thebreast bone and rib cage. Recovery from the procedure can be slow and painful.

"Annie and her parents felt that surgery was the best choice but worried about the risks." The young teen also had cosmetic concerns. "I didn't want a huge, ugly scar," she says. Dr. Bethencourt had a solution. He suggested performing the operation at the MemorialCare Heart and Vascular Institute at Long Beach Memorial using a surgical robot.

This breakthrough technology enables surgeons to operate with unprecedented precision through very small incisions. Rather than performing the surgery directly, the surgeon guides the operation from a console near the operating table. The surgeon's natural hand movements are seamlessly transmitted to robotic arms manipulating surgical instruments inside the patient. Throughout the procedure, a special camera provides a highly magnified, three-dimensional view of the surgical site. For patients, the benefits of robotic surgery can be significant, including less blood loss, a shorter hospital stay, a faster recovery and minimal scarring.

Revolutionary Care

Annie spent just two days in the hospital. She began taking walks within days after surgery and was cleared to play soccer three months later. In the spring of 2010, on hiatus from soccer, she joined her school's cross-country team. Today, her four tiny scars are barely visible. "Overall, the experience was great. This was the best decision I could have made, and I couldn't be happier with the results," she says. According to Dr. Bethencourt, Annie's experience isn't unique. "With robotic technology, we don't need to open the chest. It's revolutionary."

Now the goal is to bring this technology to the Orange Coast Memorial community. A surgical robot will enable the hospital's heart program, an extension of Long Beach Memorial's Heart and Vascular Institute, to offer the world's most revolutionary surgical care to cardiac patients.

To learn more about the achievements of the da Vinci® S Surgical System Fundraising Project at the Orange Coast Memorial Foundation.