Robotic Surgery Institute

Robotic Cardiac Surgery

When Vaughn A. Starnes, M.D., professor and chairman of the Department of Cardiothoracic Surgery at the Keck School of Medicine of the University of Southern California, took a seat at the instrument control console of the da Vinci Surgical System on April 27, 2001, he prepared to make history yet again--becoming the first cardiothoracic surgeon in Southern California to perform heart surgery using a robot.

Cross-section showing valves of the heart.

And as Dr. Starnes methodically repaired Lottie Henderson’s leaky mitral valve, USC Cardiothoracic Surgeons entered a new era of advanced heart surgery.

During this ground-breaking procedure, Dr. Starnes sat at a console about 8 feet away from the patient, while another surgeon positioned the three-armed, 1,000-pound robot beside her. Dr. Starnes grasped and moved highly sensitive instruments at the console while viewing Henderson’s heart – greatly magnified – on a screen. The robot precisely matched Dr. Starnes’ natural hand and wrist movements, translating them to the tiny instruments placed inside the patient through small puncture incisions.

The surgeons repaired Lottie’s leaky mitral valve. This valve, which helps pump blood through the heart, separates the heart’s upper chamber from its lower chamber. A weakened valve due to leakage can result in blood backing up into the lungs, causing the ventricle to pump more blood and producing symptoms of shortness of breath and tiredness.

The robotic procedure required three small incisions between the ribs, two for the insertion of interchangeable instruments and another for a thin, cylindrical video camera, called an endoscope. Dr. Starnes shaped and sutured tissue into place, shortening a chord (a sort of “heart string” that supports the heart valve). He also sewed a ring into place to brace the valve.

Mitral valve repair using da Vinci Surgical System

Mitral valve repairs are among those requiring the most skill from a surgeon. This is a procedure not many people across the country do – even without a robot. The robot is able to perfectly mimic the surgeon’s hand, all in a small area. The robot can be so delicate that you can carefully place sutures the size of a human hair.