An atrial septal defect (ASD) is a congenital defect where there is an opening in the wall between chambers (atria) of the heart. There are minimally invasive approaches to fixing an atrial septal defect, but it depends on the size, shape, and location of the defect. A small defect can be conservatively followed without surgery. But a larger one does need surgery.
The most common surgical approach requires the surgeon to open the breastbone and spread the edges for direct access to the heart. There are two minimally-invasive alternatives – a mini-ASD repair and a robotic ASD repair.
A mini-ASD repair uses a “mini-thoracotomy” which consists of a three-inch incision made through the right side of your chest between your ribs. The heart-lung bypass, required to stop your heart long enough for the surgeon to close the defect, is instituted with small tubes placed in the main artery and vein of your right leg through a one to two inch incision placed in the right groin crease. Your heart will then be stopped and the right atrium opened to expose the ASD. At this point, the surgeon will insert specialized hand-held “chopstick” like instruments through the incision to repair the defect. Once the defect is repaired, your heart will be closed and restarted. You will be disconnected from the heart-lung bypass and the incision will be closed.
In a robotic-ASD repair, the surgeon uses a surgical robotic system instead of hand-operated instruments. The da Vinci robotic system is currently the most technologically advanced surgical robotic system in the world. It is designed to perform complex operation through incisions that are much smaller and less traumatic than those used with traditional surgical approaches.
The da Vinci robotic system has four parts – a console for the surgeon, a computerized control system, two “arms,” and a fiber optic camera. The surgeon sits at the console and views the heart in magnified, highly detailed, full colored, three-dimensional images through the camera while manipulating the arms. The computers and robot mimic the surgeon's hand motions and allows the fine tips of the robot's arms to perform delicate surgery in small incisions.