Sarasota Cardiac & Thoracic Surgery

Minimally Invasive Program

Minimally invasive techniques-which drastically reduce complications, pain, scarring and recovery time associated with surgery-are available to treat a range of conditions, including valve disease, coronary artery disease ("off-pump procedures"), arrhythmias, atrial fibrillation, heart failure, thoracic aneurysms and repair atrial septal defects.

Minimally invasive heart valve surgery

Minimally invasive heart valve surgery is a technique that uses smaller incisions to repair or replace heart valves. This means there is less pain. Minimally invasive surgery also reduces the length of the hospital stay and recovery time. Instead of a traditional sternotomy incision (through the breast bone) a smaller thoracotomy (right chest) incision is made. This speeds recovery time and minimizes post-operative activity limitations.

In many cases, minimally invasive valve surgery can be done using a robot. Dr. Lewis utilizes the da Vinci® Surgical System to perform delicate cardiac procedures.This allows for greater precision and provides a highly detailed, 3-D image to replace defective valves through 1-2 cm incisions (dime size). While traditional cardiac surgery requires approximately two months of recovery with no lifting, normal activities can be resumed in as little as one week after robotic surgery.

Minimally Invasive FAQs

What is robotic assisted surgery?

Robotic-assisted surgery is a new way of performing minimally invasive surgery by incorporating techniques that allows a surgeon to operate through several small incisions about the size of a dime.

Who is using robotic Surgery?

Robotic Surgery is being used worldwide for performing a variety of surgical procedures.

Who is actually performing the surgery? Will it be the robot or the surgeon?

The surgeon will actually use the robot to assist him/her to perform the surgery.

What is the da Vinci® Surgical System?

The da Vinci® Surgical System is a totally "intuitive" laparoscopic surgical robot. It's not a robot in the sense of one you would imagine but one that integrates the latest advancements in robotics, computer-enhanced technology and the surgeon's skill. The system consists of several components: a surgeon console, patient-side chart, instruments, and image processing equipment.

What types of procedures are being done using the da Vinci® System?

Today, the da Vinci® Surgical System is being used to help surgeons perform complex procedures in major hospitals and surgical centers around the world within intracardiac, general, thoracic, and pediatric procedures.

Will the da Vinci® system make the surgeon unnecessary?

On the contrary, it is designed to enable a surgeon to be more precise, to advance his/her techniques and to enhance his/her capability to perform complex minimally invasive surgery. The System replicates a surgeon's movements in real time. It cannot be programmed, nor can it make decisions on its own to move in anyway to perform any type of surgical maneuver without a surgeon's input.

What are the benefits of using the da Vinci® Surgical System over more traditional methods of surgery?

Some of the major benefits experienced by surgeons using the da Vinci® Surgical System over traditional minimally invasive surgery have been greater surgical precision, increased range of motion, improved dexterity and enhanced 3D visualization. Benefits patients have experienced over open surgery include: shorter hospital stay, less pain, less risk of infection, less blood loss and transfusions, less scarring and faster recovery and return to normal daily activities. None of these can be guaranteed, as surgery can be both patient and procedure specific.

Minimally invasive CABG- "Off-Pump"

Off-pump bypass surgery is considered minimally invasive. The heart-lung machine is not used. Rather than stopping the heart, technological advances and new kinds of operating equipment now allow the surgeon to hold portions of the heart stable during surgery. With a particular area of the heart stabilized, the surgeon can bypass the blocked artery in a highly controlled operative environment. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.

Off-pump coronary artery bypass surgery may be performed in certain patients with coronary artery disease. With our present technology, all arteries on the heart can be bypassed off-pump. It may be ideal for certain patients who are at increased risk for complications from cardiopulmonary bypass, such as those who have heavy aortic calcification, carotid artery stenosis, prior stroke, or compromised pulmonary or renal function. Not all patients are candidates. The selection of which patients undergo off-pump surgery is made at the time of operation when the patient's heart and arteries are evaluated more closely.

Endoscopic vein harvest

Dr.  Beggs routinely performs endoscopic vein harvesting on almost all coronary artery bypass patients. Various studies indicate that Endoscopic Vein Harvest is the preferred method of harvesting veins for coronary bypass surgery. With conventional vein removal, a long incision is made in the selected leg from the ankle to the mid-thigh. With endoscopic vein removal, a small incision (one inch or less) is made just above the knee. The vein is then removed using a small flexible scope. The rate of infection with Endoscopic Vein Harvesting is drastically reduced and there is much less swelling (edema) of the leg. It does not add to the length of the surgery or to the length of the hospital stay. There is also a dramatic reduction in pain. In addition, the incision behind the knee is barely noticeable, and the cosmetic effect is well received by patients.

ASD repair

A relatively common congenital heart defect, an atrial septal defect refers to a hole in the wall separating the top two chambers of the heart. This hole allows already oxygenated blood to flow back to the lungs, reducing the heart's efficiency and eventually leading to pulmonary hypertension and other complications. Surgical repair is typically recommended.

The repair has traditionally been performed through a sternal incision. However, through the development of minimally invasive techniques this rather simple operation can be completed via a 4 cm incision in the right chest wall. Soon the surgery will be performed routinely under robotic assistance with pinhole incisions. Ask your surgeon at the time of your consultation if you are a candidate for this procedure.

Video assisted thoracoscopy

A VATs (video assisted thoracoscopy) is a procedure that involves the use of a thin, fiberoptic scope with a camera attached. Instruments can then be inserted into the chest through small incisions made between the ribs. This allows your surgeon to take biopsies, confirm a diagnosis, and perform wedge resections (remove a section of the lung). A chest tube will be placed at the time of the procedure to drain any fluids from surgery and help re-expand the lung. This will be removed when the drainage has stopped and there are no further air leaks, usually in a few days. The site will be tender for several weeks afterward and you will be discharged with pain medications. You will have no activity restrictions with the exception that you must not drive when using pain medications.