Thursday, July 12, 2018

Week 5: Robotic Open Heart Surgery and a Clinical Study


This week, I had the opportunity to observe Dr. T. Sloane Guy (https://weillcornell.org/sloaneguy) perform a robotic open heart surgery. I know that I have said this nearly every week, but this was by far the coolest and most impressive thing that I have seen so far during my immersion term!

To perform the surgery, Dr. Guy and the surgical team were aided by a daVinci Xi surgical robot. Prior to starting the robotic portion of the surgery, the team placed the patient on bypass (to remove blood flow from the heart for the operation, so that it is oxygenated outside of the body by a heart-lung machine) and inserted several small (2-3cm) cannulas on the side of the patient’s chest for surgical access. The daVinci Xi robot (see image below) has four arms with interchangeable tool tips that may be used through the cannulas, and the PA and fellow were manually modulating the camera and various surgical tools, such as sutures, through the other cannulas. The robot is controlled by the surgeon through a separate machine (shown on left side of image below) with a screen showing a 3D view of the endoscope, actuating surgical tool-like handles and several foot pedals with which he can control the robotic arms.

During the surgery, Dr. Guy performed a mitral valve repair (annuloplasty) by placing a stiff, c-shaped ring support around the valve and by adding artificial chordae, which connect the mitral valve to the papillary muscles in the left ventricle. I would never have been able to image how effective these repair mechanisms are without seeing it firsthand (in the actual heart!), and it was really unbelievable to have the opportunity to look into the 3D video of the inside of the heart as the surgery was being performed.

This week, I also participated in Hania’s clinical study to assess whether fluorescein drops affect topographical measurements of the eye. As someone who has had glasses since 2nd grade, I found it fascinating and enlightening to see and understand how the same machines that are used at all of my eye appointments work (such as to measure the prescription or the topography). I even got to see the data on how my eye is shaped! (see image below)

The topography of my right eye.


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