Thank you, I've talked to a few CT surgeons and basically heard close to the same thing. Welcome to the site. When will you be having surgery?
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Thank you, I've talked to a few CT surgeons and basically heard close to the same thing. Welcome to the site. When will you be having surgery?
Jkm7
Well-known member
My surgeon offered me choice of either method for my mitral repair/replacement. When I told him my preference was to do another open chest, he said fine and commented he had better view that way. (This was my second OHS and he had done the first.)
L
Lisa in Katy
I understand the view issue, but why would it be more painful?
Lisa:
One surgeon told John & me that it's because the ribs are spread and muscles are either cut or stretched, causing pain, and that there's no nerves in the sternum.
I had quite a bit of pain with my sternotomy. John did not have much pain with his thoracotomy. I went through 2 bottles of Rx pain meds; John only went through one. I usually have a high pain threshhold, John does not. Go figure.
Would be interesting to clone one of us and have each clone undergo OHS -- one via sternotomy and the other via thoracotomy -- and see which clone encountered more pain.
ponytaila1a
Well-known member
Are we comparing the thoractomy or the minimal invasive using a small camera and the robot? My surgeon tells me the carmera will give him a view from behind the heart which is where he needs to see my mitral valve problem. Entry will be through the ribs. Also....several on this site have had the robot and report minimum pain....In addition, I was give a choice of minimal invasive which meant a sternotomy but a "shorter" incision and a "partial" sternum breakage. Minimal invasive means many things.
They cut threw muscles, which are supposed to hurt more than the bone.
ponytaila1a
Well-known member
From the Cleveland Clinic website:
"Compared with traditional surgery, the benefits of robotically-assisted surgery include:
Smaller incisions with minimal scarring
Less trauma to the patient, including less pain
Shorter hospital stay (usually 3 to 4 days)
Decreased use of pain medications
Less bleeding
Decreased risk of infection
Shorter recovery and quicker return to daily and professional activities: The patient can resume normal activities and work as soon as he or she feels up to it; there are no specific activity restrictions after robotically-assisted surgery"
The website states that this approach is not for every patient and individual records must be reviewed before the decision is made...but seems to dispel the "more painful" idea and brings out a good point about leaving the hospital sooner which I see as a positive to minimize the chance of infections contracted in the hospital setting..
"Compared with traditional surgery, the benefits of robotically-assisted surgery include:
Smaller incisions with minimal scarring
Less trauma to the patient, including less pain
Shorter hospital stay (usually 3 to 4 days)
Decreased use of pain medications
Less bleeding
Decreased risk of infection
Shorter recovery and quicker return to daily and professional activities: The patient can resume normal activities and work as soon as he or she feels up to it; there are no specific activity restrictions after robotically-assisted surgery"
The website states that this approach is not for every patient and individual records must be reviewed before the decision is made...but seems to dispel the "more painful" idea and brings out a good point about leaving the hospital sooner which I see as a positive to minimize the chance of infections contracted in the hospital setting..
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deek
Well-known member
Thanks for this information. I'm due to have MVR on March 20th and have been given the option of having a partial sternotomy or mini thoractomy and am trying to decide between the two. Haven't been able to find much information here so I found your post very helpful. Thanks and best of luck to you!
Dee
Dee
I googled "thoracotomy" and "muscle" and found articles on "muscle-sparing" techniques.
So ... a surgeon doesn't have to cut through muscles. I'm assuming that Dr. Ryan "spared" John's muscles, since he had relatively little pain or soreness.
So ... a surgeon doesn't have to cut through muscles. I'm assuming that Dr. Ryan "spared" John's muscles, since he had relatively little pain or soreness.
E
Espoe
I have been all over this board and the web researching this one. What I have discovered is the pain factor seems to be the same for both. They each have specific pain points But the recovery is seems to be shorter for the less invasive in general, but not always.
The healing of the sternum definitely is a consideration since it takes from 12-20 weeks to heal from what I have read. Again each person is different so you can't say for certain. With the less invasive procedure you don't have this problem at all. The mini sternotomy is better since you don't split nearly as much of the sternum, leaving a more stable platform from which to heal. From what I read recovery for this one was shorter.
The less invasive procedures do seem to have a down side and that's more time on the bypass machine. There are side effects to that including memory loss, lung issues and higher risks. Again the reports on this board didn't seem to indicate anyone had any particular problem associated with that.
My definition of recovery was back to work and active. From what i read it was quicker with the less invasive procedures but not by much. For every fan of less invasive I could find a person counter to that opinion and vice versa.
Access to different procedures also played into my decision. Less invasive procedures required me to leave town. In the end because of other circumstances I will be going the sternotomy route but after all of the research I did, I never found anything that was absolutely conclusive about one versus the other. It is up to you, your circumstances and your surgeon.
The healing of the sternum definitely is a consideration since it takes from 12-20 weeks to heal from what I have read. Again each person is different so you can't say for certain. With the less invasive procedure you don't have this problem at all. The mini sternotomy is better since you don't split nearly as much of the sternum, leaving a more stable platform from which to heal. From what I read recovery for this one was shorter.
The less invasive procedures do seem to have a down side and that's more time on the bypass machine. There are side effects to that including memory loss, lung issues and higher risks. Again the reports on this board didn't seem to indicate anyone had any particular problem associated with that.
My definition of recovery was back to work and active. From what i read it was quicker with the less invasive procedures but not by much. For every fan of less invasive I could find a person counter to that opinion and vice versa.
Access to different procedures also played into my decision. Less invasive procedures required me to leave town. In the end because of other circumstances I will be going the sternotomy route but after all of the research I did, I never found anything that was absolutely conclusive about one versus the other. It is up to you, your circumstances and your surgeon.
ponytaila1a
Well-known member
Glad you made your decision. I struggled with it....but have decided on the minimal invasive using the da Vinci robot. According to the web chat at Cleveland Clinic...."in the hands of a skilled surgeon times on the pump are about the same". Best wishes and keep us posted as your date approaches.
DarrinDNelson
Member
Robotic vs Traditional
Robotic vs Traditional
Greetings all. I am sitting in the airport in Rochester MN, awaiting my flight home to Rochester NY after completing 2 full days of tests here at the Mayo Clinic.
About 8 years ago I was diagnosed with moderate mitral valve prolapse and regurgitation. Unfortunately, it has progressed to severe and I now have to schedule surgery.
I am still a very active 44 yr old male (playing soccer 2 days/week as well as in the weight room 2 days/week).
Fortunately, Dr. Schaff (my surgeon under consideration) is optimistic about being able to be repaired.
While there, one of the cardio nurses also mentioned the advancements being made in robotic surgery -> http://mayo.dayport.com/viewer/content/special.php?Art_ID=917&Format_ID=2&BitRate_ID=8 and that I should consider speaking w/Dr. Suri for consideration of this procedure.
In the past 24 hours I've been speaking to anyone I could about this procedure here at Mayo...and there seems to be 2 camps - fairly evenly split.
Those in favor of the robotic list the primary benefit as recovery time - the video above shows a case of a guy fairly active within 2 weeks of the surgery.
While those in favor of traditional OHS liken the robotic surgery to that of trying to shave somone while sitting in the next room....and that while the length of recovery when splitting the sternum are a bit longer, they do allow the surgeon optimal view and freedom of their target as well as there seems to be a bit more mental side effects (confusion, memory loss, etc..) due to being under longer and on the heart/lung machine longer
I asked my cardiologist if he were to have to have this surgery which route would he go - he chose traditional as he felt that gave him the best chances for optimal results.
I am still in fact finding mode, but just wanted to post what I have learned the past 2 days.
It's been a tough couple of days. Looks like will have my surgery no later than July.
Robotic vs Traditional
Greetings all. I am sitting in the airport in Rochester MN, awaiting my flight home to Rochester NY after completing 2 full days of tests here at the Mayo Clinic.
About 8 years ago I was diagnosed with moderate mitral valve prolapse and regurgitation. Unfortunately, it has progressed to severe and I now have to schedule surgery.
I am still a very active 44 yr old male (playing soccer 2 days/week as well as in the weight room 2 days/week).
Fortunately, Dr. Schaff (my surgeon under consideration) is optimistic about being able to be repaired.
While there, one of the cardio nurses also mentioned the advancements being made in robotic surgery -> http://mayo.dayport.com/viewer/content/special.php?Art_ID=917&Format_ID=2&BitRate_ID=8 and that I should consider speaking w/Dr. Suri for consideration of this procedure.
In the past 24 hours I've been speaking to anyone I could about this procedure here at Mayo...and there seems to be 2 camps - fairly evenly split.
Those in favor of the robotic list the primary benefit as recovery time - the video above shows a case of a guy fairly active within 2 weeks of the surgery.
While those in favor of traditional OHS liken the robotic surgery to that of trying to shave somone while sitting in the next room....and that while the length of recovery when splitting the sternum are a bit longer, they do allow the surgeon optimal view and freedom of their target as well as there seems to be a bit more mental side effects (confusion, memory loss, etc..) due to being under longer and on the heart/lung machine longer
I asked my cardiologist if he were to have to have this surgery which route would he go - he chose traditional as he felt that gave him the best chances for optimal results.
I am still in fact finding mode, but just wanted to post what I have learned the past 2 days.
It's been a tough couple of days. Looks like will have my surgery no later than July.
ponytaila1a
Well-known member
Yes, I am "freaky" about the chest split thing and favored the robot....but one surgeon mentioned the fact that they have done thousands of "traditional" but only "hundreds" of robotic assisted. I am going robotic if after the consult with the surgeon he confirms that. I have spoken with several patients who experienced the robotic assisted method.
Their ages are from 40's to one man 82.....all feel they would opt for the method again.
I also watched a video showing a woman news anchor in Atlanta who had her entire surgery pre .....through recovery filmed.......she had the da Vinci robotic in Atlanta...she was younger than I (35ish....compared to my 63ish) but her recovery was amazing.
A surgeon I consulted with also mentioned that per my TEE the damage is on the "back" of my heart (whatever that means) and the view would be better using the camera than going in from the front. I am just trusting my surgeon (s).
http://my.clevelandclinic.org/heart/webchat/gillinov42507.aspx
http://my.clevelandclinic.org/heart...alve_surgery_gillinov_webchat_transcript.aspx
A couple "web chats" by Dr Gillinov at Cleveland Clinic discussing latest innovations in minimal invasive surgery.
Their ages are from 40's to one man 82.....all feel they would opt for the method again.
I also watched a video showing a woman news anchor in Atlanta who had her entire surgery pre .....through recovery filmed.......she had the da Vinci robotic in Atlanta...she was younger than I (35ish....compared to my 63ish) but her recovery was amazing.
A surgeon I consulted with also mentioned that per my TEE the damage is on the "back" of my heart (whatever that means) and the view would be better using the camera than going in from the front. I am just trusting my surgeon (s).
http://my.clevelandclinic.org/heart/webchat/gillinov42507.aspx
http://my.clevelandclinic.org/heart...alve_surgery_gillinov_webchat_transcript.aspx
A couple "web chats" by Dr Gillinov at Cleveland Clinic discussing latest innovations in minimal invasive surgery.
