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Robotic Surgery: Cardiovascular Procedures


Our Surgeons

The experience of our robotic surgeons at Lenox Hill Hospital is unparalleled. To date, our team has performed more than 1,500 minimally invasive direct coronary bypass procedures, which is the most in the country.

Robotic Cardiac Surgery

Performed without opening the chest, access to the heart in robotic surgery is achieved by inserting tiny robotic arms into small incisions made by the ribs. These robotic arms (Intuitive Endowrist® instruments) operate like the human hand via tiny joints that bend like wrists and fingers. The surgeon controls the robotic arms through a sophisticated computerized motion controller at a master console in the operating room. With this technology providing 3D high definition vision, which is magnified six times, the surgeon can perform complex cutting and sewing with unparalleled precision.

By utilizing robotics in cardiac surgery, our surgeons are able to perform procedures with the smallest incisions possible.

Procedures performed by our surgeons utilizing this technology include:

  • Atrial Fibrillation Surgery
  • Direct Coronary Bypass
  • Mitral Valve Repair
  • Robotic Closure of ASD (hole in heart)
  • Robotic Implantation of Heart Failure Devices
  • Totally Endoscopic Coronary Bypass

Atrial Fibrillation Surgery

Atrial When the receiving chamber of the heart (the atrium) becomes enlarged, this causes an irregular heart rhythm. This irregular rhythm can lead to palpitations, stagnation of blood inside the heart and the formation of clots that can cause paralysis or stroke. While this condition is commonly treated with medications to slow the heart rate and thin the blood, the long-term use of these medications has significant side effects.

To eliminate the need for medication, we perform ablation using various energy sources to create scars in the atrium to stop the accelerated heart rate. Our surgeons were the first in the world to perform the robotic isolation of pulmonary veins for atrial fibrillation, instead of the traditional catheter ablation which leads to high percentage of recurrence.

Direct Coronary Artery Bypass

Our surgeons perform this procedure on a patient’s beating heart through a three-inch incision, without the support of a heart-lung machine. Our surgeons utilize robotic surgical technology to access the entire length of the the artery below the breast bone (the internal mammary artery) via a small incision and with minimal rib spreading. The surgeon then performs the bypass on the beating heart using specialized instruments to stabilize the heart during the procedure.

Mitral Valve Repair Surgery

The goal of a mitral valve repair is to correct the diseased valve and achieve a normal functioning valve to last for the life span of the patient. This repair requires complex techniques, and our Dr. Nirav Patel is one of the few surgeons who regularly perform this procedure.

Found near the back of the heart, the mitral valve prevents blood from flooding the lungs when the left ventricle (the pumping chamber) pumps blood through the body. Leakage occurs when one of the two strings suspending the two leaflets of the valve elongates or ruptures. In this scenario, valve repair provides the best long-term outcome.

In traditional procedures, surgeons approach the mitral valve through the breast bone in the front of the chest and then work around the right side of the heart to gain access to the structures. Our surgeons experience improves upon this traditional approach by using a three inch incision on the right side of the chest to approach the valve. The surgeon can then work with direct exposure to the valve with the assistance of long-shafted specialized instruments, scopes and television monitors. The majority of leaking mitral valves that we treat are repaired through these minimally invasive methods.

Comparison Incision

Robotic Closure of ASD (Atrial septal defect)

Our facility was one of the few sites in the country to participate in the pioneering trial which led to approval of robotic surgery for this procedure.

About four to eight percent of the population is born with an atrial septal defect, which is a hole in the partition of the receiving chambers of the heart. If not closed, this defect can lead to permanent damage to the lungs. In some cases, a small hole may be closed by using a catheter inserted into the patient’s groin. In cases of larger defects, surgical closure is necessary.

Our skilled surgeons use minimally invasive robotic technology to fix these larger holes via very small incisions on the right side of the patient’s chest (underneath the breast for female patients).

Robotic Implantation of Heart Failure Devices

Traditionally, patients had heart failure devices like pace makers implanted through a large chest opening. The robotic technologies utilized by our team allow these devices to be implanted through small, pencil-sized incisions, where they can synchronize the patient’s heartbeat and improve heart failure.

Totally Endoscopic Coronary Artery Bypass

Our cardiac department is one of the few in the Northeast regularly performing this procedure on a beating heart, and Dr. Nirav Patel is one of the few surgeons in the world performing this surgery on a regular basis.

This procedure is the most minimally invasive bypass surgery. Our surgeons perform this bypass on a beating heart through four pencil-sized holes with robotic instrumentation, removing the need for large incisions or rib spreading. Specialized endoscopic instruments allow our surgeons to perform the precise suturing necessary for a successful bypass surgery. Patients having this surgery typically have very rapid recovery rates, and many return to normal life activities in days rather than weeks.

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