First robotic double valve surgery done in Chennai

The unprecedented surgery was done Feb 21 by the doctors from the Institute of Cardio Vascular Disease in the Health City on 23-year-old P. Vijayakanth.

Chennai: A team of cardiac surgeons at the Chettinad Health City here has performed what is claimed to be the world`s first simultaneous replacement of two heart valves through robotic technology, a team doctor said here Friday.
The unprecedented surgery was done Feb 21 by the doctors from the Institute of Cardio Vascular Disease in the Health City on 23-year-old P. Vijayakanth.

"This is the first time in the world a double valve replacement heart surgery was performed with the assistance of a robot - Da Vinci," R. Ravi Kumar, director of the Institute of Cardio Vascular Disease, told IANS.

Kumar, a US-returned veteran cardiac surgeon for over 40 years, was the first to perform the mitral and aortic valve replacement surgeries in India using a robot.

According to him, Vijayakanth was diagnosed to have rheumatic valvular disease with mitral and aortic valve regurtation (blood leak).

He was complaining of shortness of breath even while resting and could walk only about only 10 to 15 feet, Kumar said.

The patient was put on a bypass machine and the heart was stopped. Using robotic assistance, both the valves were removed and replaced with mechanical mitral and aortic valves, Kumar explained.

"One valve is made by Indian company TTK Pharma and the other is from St. Jude`s of the US," he said.

The Da Vinci robotic system, made by the US firm Intuitive Surgical Inc, consists of three segments - the console offering 3D high definition pictures of the patient`s body to be operated by the surgeon few feet away from the patient, the robot with three octopus-like arms - one with a camera and two to carry out the surgery - and a monitor for the operating team to view the procedure.

"The surgeon will operate two joy-stick like handles that control the two arms of the robot to carry out the precise surgical procedures," Kumar said.

He added: "Cardiac surgery with the assistance of a robot was first introduced in the year 2000. The first mitral valve was repaired by an American doctor Randolph Chitwood. Over the decade, many attempts and advances have been made in robotic surgery to replace and repair heart valves."

Though single valve repairs and replacements in mitral position have been successful since the beginning, double valve replacement was not attempted due to its complexities, Kumar said.

According to him, a cardiac surgeon who had done not less than 500 operations could comfortably operate the robot to carry out the remote surgery.

Asked about the advantages of robotic surgery, Kumar explained: "The incision size will be small, which in turn has advantages like lower blood loss and infection rates, faster recovery and lower pain for the patient. There won`t be any big scar."

In Vijayakanth`s case, the incision size was just four centimetres. Had it been a traditional operation the cut size would have been 22 centimetres. Further, in normal heart surgeries the rib bone will be cut and it would take some months to heal. Here the bone was not cut," Kumar said.

The patient can return to work in three weeks as against three months of rest under the traditional surgical method, he added.

Kumar also said Chettinad Health City is planning to start a robotic surgery training centre for surgeons.