Surgeon pioneers minimally invasive ‘heart’ surgery
University of Chicago’s Sudhir Srivastava, MD, is a leading surgeon on minimally invasive coronary artery bypass surgery.
It’s the difference between looking through a spyglass and a pair of binoculars.
With the former, one closes an eye, peers into the eyepiece, and uses the curved lenses to gaze at objects of interest. But with binoculars, one merges the lenses together to create depth perception—a historic departure from the older, telescopic model.
At the University of Chicago Medical Center, pioneering surgeon Sudhir Srivastava uses an innovative robot to define the binocular standard for coronary artery bypasses—where the area of focus is not a tapestry of twinkling stars, but the human heart.
Srivastava, one of only two surgeons worldwide who has performed a large number of complex, robot-assisted coronary artery bypass surgeries, came to Chicago in July 2007 after establishing a reputation as a robot-assisted surgery pioneer at Alliance Hospital in Odessa, Texas, where he was founding chairman.
“After doing it hundreds of times,” Srivastava said, “I almost feel the machine is no longer between me and the patient.”
da Vinci Robot
Since then, he has performed 60 coronary bypass graft procedures at the Medical Center using the da Vinci robot, a special machine that allows doctors to offer surgeries involving less pain, little blood loss, a reduced risk of infection and a shorter hospital stay than their conventional counterparts—all with equivalent or better clinical outcomes.
His patients leave the hospital in just a few days.
Until several years ago, such a rapid recovery was unheard of. Conventional bypass surgery—known as the gold standard for coronary artery disease—requires months for a patient to fully heal.
Throughout the United States, 80 percent of coronary artery bypasses are performed conventionally, by splitting the sternum and rerouting the patient’s blood to a heart-lung machine. Shifting of the reconnected breast bone and the occasional inflammatory response to the re-pumped blood can make the recovery process painful and cumbersome.
But neither problem occurs following the robotic opertion that Srivastava has perfected. He usually performs the surgery “off pump,” allowing the heart to continue to beat.
And the sternum is undisturbed. Instead of going into the chest with a big incision, the da Vinci robot enables the surgeon to operate through four or five small holes created in the side of the chest. A camera goes into one of the holes, instruments though the others, and the surgeon operates from a console a few feet away.
Intuitive, Precise Movement
As with binoculars, the magnification of the da Vinci robot is much greater than what surgeons would see with their eyes, allowing for enhanced close-up vision and precision of movement.
“My hands and feet move in a way that’s totally intuitive. That is achievable,” Srivastava said. “You almost develop this sixth sense where looking at what you’re doing gives you pseudo-tactile feedback.”
In Texas, he remained an anomaly among cardiothoracic surgeons, with patients discovering him from the Internet and coming from around the world for their bypass surgeries. Since joining the Chicago faculty, however, word has spread about Srivastava’s mission.
In an April 30 cover story in USA Today, Srivastava said moving to the Medical Center provided him with a once-in-a-lifetime opportunity to “spread the gospel of robotic bypass surgery.”
“That’s the vision,” he said.
By Megan Seery
