June 2022. Just a few weeks ago, in the halls of Humanitas Gavazzeni in Bergamo, the first “official” robotic cardiac surgery operation in Europe was carried out with the joint use of robots and smart glasses. Remaining at a distance of hundreds of kilometers, the surgeon is able to participate directly in the operation that is taking place. The special devices in fact offer the possibility of exploiting augmented reality by displaying images and videos on the lens display as well as allowing listening without the use of earphones.
The first intervention was a coronary by-pass with a beating heart with removal of the mammary artery through the robot. And it was created by the team of Alfonso Agninohead of Robotic and Minimally Invasive Cardiac Surgery of Humanitas Gavazzeni.
The specialist is far away
The peculiarity of this operation consists precisely in the joint use of “smart” glasses and the robot for cardiac surgery. In fact, the smartglasses made it possible to participate in the operation Wouter OosterlinkEuropean referent for minimally invasive robotic coronary surgery, who at that time was in Leuven, Belgium.
Operate remotely
Thanks to technology and constant contact with the eyewear operator, Oosterlink was able to witness the intervention live, from Agnino’s perspective, exactly as if he had been present in the Bergamo operating room. The intervention was an important training opportunity on the use of technologies available for heart care that paves the way for the use of augmented reality and still unexplored worlds in the health sector.
Heart under control at home, so the hospital will be more and more virtual
in collaboration with the Cardiology Network IRCSS & NExT-H
What changes with the robot
The robot is a cybernetic ally that strengthens and improves the surgical technique. It helps to move the instruments inside the heart with joints capable of rotating 360 degrees and can operate by completely eliminating a possible tremor in the hands. The surgical gesture that is carried out with the opening of the sternum, in traditional surgery, or through incisions of the chest, in minimally invasive surgery, with the robot is made with small holes of 8 millimeters and small incisions of 2 centimeters without spreading the ribs.
“This allows the surgical impact to be reduced exponentially with obvious benefits for the patient not only from an aesthetic point of view (since he does not have a scar on his chest), but also in terms of pain, bleeding and of the infectious risk and a quick post-operative recovery “, adds Agnino.
Experience on the mitral valve
More than 150 operations have already been performed on the team’s mitral valve, using the robot. Today these advances were at the center of the international conference “The new age of mitral therapy“scheduled at the congress center in Bergamo.” The minimally invasive technique, if possible, is always recommended as it allows to minimize the impact of the intervention avoiding the “sternotomy”, that is the opening of the chest – Agnino specifies. This translates into less risk for the patient and faster recovery “.
All patients are eligible except those with a previous pathology that required surgery on the right side of the chest, patients with previous right pleurisy, patients with previous right thoracic trauma or in the presence of congenital conditions of deformation of the sternum such as the so-called “pectus excavatum” . Basically, in expert hands, the indication is given not by the type of valve pathology that is being treated, but by the anatomical conditions of the chest along the ways to reach the heart.
Mitral valve, to repair it the surgeon becomes a “tailor” of precision
How the mitral valve gets sick
The mitral valve opens and closes in each of us about 100,000 times a day. It is placed between the left atrium and the left ventricle of our heart which has the task of ensuring that the blood makes its right path, ensuring the correct exchange of oxygen and carbon dioxide. But sometimes the valve can get sick, presenting a stenosis, that is a narrowing, or what is called insufficiency, that is a leak or prolapse. If it is too tight, the valve does not allow blood to enter the ventricle, making it difficult for blood to pass from the pulmonary circulation to the left ventricle.
Mitral insufficiency
Mitral insufficiency, on the other hand, is a defect in the closure of the mitral valve that causes part of the blood pumped from the left ventricle to flow back into the left atrium instead of going into the aorta: it therefore means that the flow is reversed, instead of going into the right direction goes back to the lungs. Regarding both stenosis and insufficiency, the symptoms – often not present at the beginning of the disease – are fatigue, cough, palpitations and respiratory disturbances. Unfortunately, this is a symptomatology common to other pathologies, which therefore makes diagnosis very often complex when, on the other hand, the early recognition of the picture allows it to be dealt with in the best possible way.
Heart door
Bad habits for heart health, so an app will help us fight them
in collaboration with the Cardiology Network IRCSS & NExT-H
