The Guerrieri Heart & Vascular Institute at Peninsula Regional Medical Center is the only heart program in Maryland or Delaware currently using the da Vinci S High Definition Surgical System Robot to assist in minimally invasive coronary artery bypass surgery. For select patients who meet the qualifications, the use of the da Vinci robot and minimally invasive surgical techniques means there is no need for a large chest incision and a separation of the ribs during open heart surgery.

The trend-setting robotic heart surgery was performed off-pump (on a beating heart without the assistance of a heart and lung machine) for the first time on the Delmarva Peninsula at Peninsula Regional Medical Center by cardiothoracic surgeon Kurt E. Wehberg, MD. “We’ve recently performed two of the specialized surgeries using the da Vinci robot and both were phenomenal successes,” said Dr. Wehberg. “In fact, one patient who underwent double bypass was home within three days and back to a completely normal lifestyle, minus the debilitating heart pain, in just one week.”

Dr. Wehberg and cardiothoracic surgeons James C. Todd, III, MD and Nicholas Ogburn, MD have been specially trained to use the da Vinci robot to remove the left internal mammary artery (LIMA) from a patient’s chest, via three small incisions: one in the left armpit, one under the left breast and a third in the left lower ribs. The LIMA, once dissected, is then used by surgeons as a bypass around a heart artery blockage. For the past four decades it has proven to be the best long-term treatment of coronary artery disease, and is the chosen artery for bypass when using the da Vinci robotic method.

The da Vinci’s state-of-the-art robotic technology exactly translates a surgeon’s hand movements from a nearby control console to the robot’s arms, which are holding surgical instruments specially designed for the LIMA dissection. The da Vinci’s robotic arms, which keep the surgical instruments very stable, permit surgeons to manipulate those instruments inside the patient with extreme precision. As well, the da Vinci robot features a high definition camera that magnifies by 10 times the view of the surgical area inside the body. The combination of better instrument stability and greatly enhanced visualization with the camera is what makes dissecting the LIMA possible through tiny incisions versus separating the ribs to remove the artery using the naked eye.

Once the LIMA has been dissected, the robot is removed from the surgical table. At that point, surgeons step in to complete the coronary artery bypass surgery-connecting the LIMA bypass to the diseased artery-by using specially designed, minimally invasive surgical instruments in the same three small incisions previously occupied by the robot’s instruments. “Completing the bypass surgery through those same small incisions is an incredible benefit for the patient,” added Dr. Todd. “Because of the robotic technology used at the front end of the operation to remove the LIMA, we can perform the entire coronary artery bypass surgery without separating the chest, and that translates into less blood loss and less pain. Additionally, patients spend 2-3 days recovering in the Medical Center versus 6-8 days when we have to separate the chest and they’re back to work in 2-3 weeks instead of 6-8 weeks.”

Future potential applications for the da Vinci robot in cardiothoracic surgery at Peninsula Regional include valve replacement and repair surgeries. It is also currently being used by select urologists at Peninsula Regional to perform minimally invasive laparoscopic prostatectomy surgery.

Drs. Wehberg and Todd, of CV Surgical Associates, P.A. in Salisbury, Maryland, are the only two surgeons in Maryland or Delaware currently using da Vinci’s robotic technology to assist during bypass surgery. Their partner, Dr. Ogburn, just completed a training program and will soon begin using the da Vinci S High Definition Surgical System Robot to assist in select coronary artery bypass surgeries at Peninsula Regional Medical Center.