Dr. T. Sloane Guy<\/a>. \u00a0Dr. Guy is a robotic specialist that has helped many patients from our patient community. \u00a0Here are the highlights from our recent exchange.<\/p>\n <\/p>\n
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Dr. T. Sloane Guy<\/p>\n
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Dr. Sloane Guy Says…<\/h2>\n
In my first question, I asked, “Do you specialize in valve therapy? If so, do you sub-specialize in a specific valve?”<\/p>\n
Dr. Guy answered, “I specialize in mitral valve repair, particularly endoscopic robotic mitral valve repair. \u00a0Despite having an extremely broad background in medicine, including time in the Army as a general practitioner and general surgery, I have increasingly found that super sub-specialization has benefits. Like anything else in life, the more you do and the greater effort you put into achieve excellence, the better the results. \u00a0While this is not necessarily the path for all surgeons, for me it is. \u00a0I discovered along the way that endoscopic robotic mitral valve procedures bring out the best in me as it is a demanding procedure that demands a high level of team leadership and execution, technical skills including complex circulatory management, mitral valve repair techniques, and robotic skills along with administrative capability. \u00a0I enjoy the challenge of these advanced procedures.”<\/p>\n
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Dr. Guy Performs Robotic Mitral Valve Surgery<\/p>\n
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I then asked Dr. Guy, “Before becoming a robotic specialist, I understand you were skeptical about the robot. \u00a0What changed your mind?”<\/p>\n
Dr. Guy answered, “When the robotic system first came out around 2002, it was first-generation technology and most surgeons were doing fairly large incisions in the chest (thoracotomies) to perform these procedures. \u00a0Many criticized robotics at that time as adding too much expense and complexity to an operation that could be easily performed through the exact same incision without the robot. \u00a0I agreed with that and still agree with that if large incisions are made. What changed my mind is when I learned that a small but talented group of surgeons had persevered and developed completely endoscopic approaches with incisions in the 2-3 centimeters range (an inch) without any spreading of the ribs (which can cause pain), and the robotic endoscopic atrial retractor came around. \u00a0Having grown up in the era of laparoscopy, I knew that such incisions had to be of benefit to the patient.”<\/p>\n
I was curious to learn about the evolution of robotic valve therapy, so I asked Dr. Guy, “How has robotic mitral valve surgery changed since you got started?”<\/p>\n
Dr Guy answered, “A great deal has changed. \u00a0The initial operations involved large incisions and first generation robotic technology with only 2 arms and a camera. \u00a0We now have 4-5 generations of robotic systems with 3 arms and an HD camera and are able to do the procedures with incisions as small as 12 millimeters (the diameter of my little finger). \u00a0This makes all the difference. \u00a0You can\u2019t do a mitral valve repair with incisions that small without the robot.”<\/p>\n
I asked Dr. Guy, “What new innovations are you working on specific to robotic mitral valve repair?”<\/p>\n
Dr. Guy responded, “The innovation I am most excited about is the use of percutaneous cannulation combined with an endoscopic robotic approach. \u00a0We have borrowed from our experiences with TAVR and other endovascular techniques and are able to avoid any open incisions at all. \u00a0So currently we have four, 8 millimeter robotic ports (right arm, left arm, camera, retractor), a 12 millimeter working port in the chest and totally percutaneous cannulation for cardiopulmonary bypass and protection of the heart. \u00a0We are starting to get very positive feedback from patients, who in the past often complained about the incision in the groin — previously used to access the femoral (leg) vessels.”<\/p>\n
Lastly, I asked Dr. Guy, “What is the patient experience after robotic surgery?”<\/p>\n
Dr. Guy responded, “There is ample evidence of improved patient experience with robotic mitral valve surgery. \u00a0Currently, I would say roughly 75% of my patients are going home by postoperative day #3 and a fair number on postoperative day #2. \u00a0We have had a small handful go home on postoperative day #1 which is unheard of after traditional cardiac surgery. \u00a0I think the big shift is that we are moving away from an era where safety-and-effectiveness were the only concerns and have now added “patient experience” and “lack of invasiveness” as priorities, albeit always secondary to safety-and-effectiveness. \u00a0Many surgical specialties have embraced this concept while ours has lagged behind. \u00a0Surgeons have said that it\u2019s because our specialty is \u201charder and higher risk than others\u201d. \u00a0 I say they are wrong. \u00a0 Sure it\u2019s harder and higher risk than other procedures but we’re supposed to be better and we’re supposed to be committed to the patient and all their needs. \u00a0Our specialty has been so stagnant with innovation since the 1970\u2019s compared to other specialties — until the advent of transcatheter techniques and robotics. \u00a0Many, if not most cardiac surgeons still primarily perform procedures that were largely perfected by 1980. \u00a0The internet did not even exist then! \u00a0Think of how other areas of life have developed and changed since then. Its time to re-invigorate our specialty as many are doing now.”<\/p>\n
Many thanks to Dr. Sloane Guy for sharing his clinical experience and research with us. \u00a0It was also to great to learn about the new percutaneous cannulation innovation he and his team are working on.<\/p>\n
Keep on tickin!
\nAdam<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":27679,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[68],"tags":[],"class_list":["post-27661","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-technology"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/27661","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/comments?post=27661"}],"version-history":[{"count":0,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/27661\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media\/27679"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media?parent=27661"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/categories?post=27661"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/tags?post=27661"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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