​Robots: Surgical Helping Hand

Robots help NUHCS surgical team achieve better outcomes

PULSE Issue 39 | June 2022

On 18 Jan 2022, robots joined forces with the surgical team of cardiac and thoracic surgeons and nurses at the National University Heart Centre, Singapore (NUHCS) to perform a minimally invasive heart surgery, carrying out a successful Internal Mammary Artery (IMA) harvest – the first robot-assisted bypass surgery in Singapore. The team from the Department of Cardiac, Thoracic and Vascular Surgery (CTVS) consisting of Dr Chang Guohao, Consultant, Ms Peggy Hu, Senior Case Management Officer, and Ms Corina Lau, Nurse Clinician, coordinated this case with the support of Dr Harish Mithiran Muthiah, Senior Consultant, and Dr Lowell Leow Choong Kiat, Associate Consultant. Robot-assisted bypass surgery has been advancing around the world, with even newer technologies arising. One of the key reasons why many advanced heart centres in the world are shifting their model of care to include robots is due to positive reports of such surgeries, including reducing patients’ hospitalisation stay for recovery to an average of just three days, even for major surgeries like the Coronary Artery Bypass Graft (CABG).

There are many clear advantages for robot-assisted surgery. Robot arms are as thin as rods and needles which means that these surgeries only need much smaller cuts – down to the millimetre – to access inner parts of the body. This causes less trauma to patients thus, translating to an overall quicker recovery process. These advanced robotic systems are mostly equipped with sharp, high-resolution cameras that provide three-dimensional visualisation of the internal body. The images that show up on the screen can be further magnified many times over, allowing the surgeons controlling the robots to make very precise cuts. This feature helps to prevent the straining of surgeons' eyes and allows them to perform more complex surgeries with ease. Another key advantage of the robot is its precision in graft harvesting – a widely used technique to reduce post-surgery wound complications from heart operations. The robot has a wide range of motion which allows the surgeon to skeletonise the left IMA and right IMA with more ease. With robots, the surgical team would have better accessibility to both mammary arteries, further providing the option to perform a minimally invasive Total Arterial Revascularisation (TAR) procedure. Working with the advice and guidance of renowned experts – Dr Gianluca Torregrossa, Director of Robotic and Coronary Revascularization Program at the Lankenau Heart Institute in Philadephia, the United States of America (U.S.A.) as well as Prof Husam H Balkhy, Director of Robotic and Minimally Invasive Cardiac Surgery, the University of Chicago Medicine in Chicago, U.S.A. – the NUHCS team hopes to achieve results such as an average hospitalisation of just one to three days, similar to reports from renowned specialised cardiac centres around the world.