Macquarie University Hospital (MUH) successfully completed its first Off-Pump Coronary Artery Bypass Graft (OPCABG) using the da Vinci Xi Surgical System, the most advanced available surgical robot.

Leading Sydney heart surgeon, Professor Michael Wilson, who has been one of the pioneers of an off-pump approach to bypass surgery, performed the procedure.

Although Professor Wilson and his team have done OPCABG procedures robotically at Macquarie University Hospital using the older Si System, the Macquarie University Hospital case was the first time that the latest model – the da Vinci Xi – had been used.

Colleague Professor Michael Vallely and Professor Wilson are two of only a few surgeons worldwide who are able to perform CABG in all three modalities: traditionally, off pump and robotically.

“We’ve been doing off-pump CABG increasingly at MUH and RPA for years now, with excellent results for patients,” said Professor Wilson.

“And we’ve also done more than 1000 cases using a ‘no touch’ approach – Anaortic OPCABG – which means there is no manipulation of the aorta during revascularisation. We mobilise the mammary and radial arteries instead for blood flow.

“Research analysis of international clinical data shows that Anaortic OPCABG reduces the risk of stroke by two-thirds. What a robotic approach does is allow us to offer Anaortic OPCABG in a minimally invasive way. At the moment, we are unique in this approach.”

Forty-four-year-old patient Joanna Dean found out that she had early onset arterial disease after she developed chest pain during her daily cycling commute to work. This meant that she thought she was headed for a full sternotomy or stents, until she met with Professor Wilson and found out about Macquarie University Hospital’s new cardiothoracic robotic program.

“I’d heard of robotically assisted surgery for the heart, but I didn’t think that it was actually available now,” said Ms Dean, who returned home one week after surgery, and is fully mobile less than two weeks later.

Robotic surgery is far less invasive than traditional surgery, with patients experiencing a much faster recovery time. A four to six centimetre cut under the breast crease is all that is required to access the heart. Patients have been back to work as early as two weeks.

A second patient, considered for the same procedure as Ms Deane, had his converted to conventional surgery.

“Robotically assisted bypass surgery is a safe procedure when patients are properly screened and referred,” said Professor Wilson.

“And it’s important to remember that conventional surgery is always there as a back-up. Our priority is always patient safety, and in the case of our second patient, we decided to proceed traditionally. He had conventional bypass surgery and is recovering well.”

Macquarie University Hospital CEO Carol Bryant said that it was the Hospital’s investment in a second and more advanced robot earlier this year that has allowed the development of a robotic bypass graft program.

“We are delighted to be adding a range of robotically assisted surgeries to several other disciplines with the new da Vinci Xi Surgical System,” she said.

“These will include colorectal, gynaecological and cardiothoracic surgery, which require more movement over a larger area of the body, and more dexterity.

“It’s fantastic to see our first patient Joanne recovering so well and benefiting from our investment in this technology. This is a big advance for the private hospital sector in Australia.”