Surgeon Q&A: Top 3 Misconceptions of Robotic Mitral Valve Surgery

Cardiac surgeons have been performing robotic mitral valve surgery for over two decades. It is a minimally invasive surgery for mitral valve disease that provides patients with several advantages including less intraoperative blood loss, reduced post-operative pain, shorter hospital stays, a faster return to normal activities, and better cosmetic outcomes with less scarring compared to traditional open-heart surgery with a sternotomy.

Robotic mitral valve surgery has gained popularity over the years. However, patients have questions and misconceptions about this type of surgery. We spoke to Dr. Arnar Geirsson, Director of the Surgical Heart Valve Program at NewYork-Presbyterian Columbia Irving Medical Center in New York City, New York, to learn the top three misconceptions about mitral valve surgery. Dr. Geirsson has performed over 500 robotic mitral valve operations during his extraordinary career.

Top 3 Misconceptions of Robotic Mitral Valve Surgery

Here are the key insights shared by Dr. Geirsson:

• What is one of the big misconceptions about robotic mitral valve surgery? Dr. Geirsson said, “One of the questions I get asked a lot is, ‘Who is doing the operation?’ or ‘Is the robot doing the operation?’ In reality, I, the surgeon, do the operation. The robot is just a tool to do the operation less invasively.” He explained that the robot is at the bedside, and he sits at a special console and controls the robot. “There’s always an assistant who changes out instruments, but I actually do the operation.”

• What is the second misconception about robotic mitral valve surgery? Dr. Geirsson said that patients often ask if the outcomes of robotic versus sternotomy approaches are the same. “I think the answer is that it’s as safe and as good as a sternotomy.” He explained that the data suggests that robotics provides for a shorter hospital stay, faster recovery, and less pain compared to sternotomy. “Requiring blood transfusions and getting atrial fibrillation after the operation is less frequent with robotics. Other important questions to ask are, ‘What is the quality of the repair and how easy is it to repair the mitral valve?’ The answer is that it seems to be as good or even sometimes more reliable to repair the valve, although it’s difficult to prove. I think all the data and literature suggest that robotic surgery is as safe and effective as sternotomy or other approaches to the mitral valve.”

• What is the third misconception about the robot? “A third common question I get is, ‘Is robotic surgery open-heart surgery?’ And the answer to that is, yes, it is open-heart surgery, but it depends on how you define it. In robotic mitral valve surgery, we use a heart-lung machine, which takes over the function of the heart and lungs. So, in many ways, that qualifies as an open-heart surgery. However, we use small incisions or ports instead of opening the front of the chest. It’s really a minimally invasive cardiac surgery.”

Thanks Dr. Geirsson and NewYork-Presbyterian Columbia University Irving Medical Center!

On behalf of all the patients in our community, thank you, Dr. Arnar Geirsson, for everything you and your team are doing at New York Presbyterian Columbia University Irving Medical Center!

Related links:

• See Dr. Geirsson’s Interactive Surgeon Profile
• Explore the Columbia Structural Heart and Valve Center
• Why Robotics? Five Questions with Dr. Arnar Geirsson

Keep on tickin,
Adam

P.S. For the deaf and hard-of-hearing members of our patient community, we have provided a written transcript of our interview with Dr. Geirsson below.