EASIER TO HEAL: Mr Dudley Dragon, 80, had a heart bypass last year, a minimally invasive procedure done using a robot. He has only three small scars as a result - the longest only 5cm (above, next to nipple) - instead of the usual long scar (right photo) that takes longer to heal.


Retired teacher Dudley Dragon had a heart bypass last July, but you would not know it from looking at his chest.

Instead of the long 'zipper' scar that marks out heart bypass survivors, all he has are two 2cm long scars and a 5cm long one.

His surgeons at the National Heart Centre (NHC) used a robot to perform minimally invasive 'keyhole' surgery.

That meant he was spared from having to have his breast bone sawn open - a painful feature of conventional bypass surgery.

His doctors could also operate while his heart was beating, so it did not need to be stopped and restarted.

Mr Dragon, 80, who went home after five days in hospital, said: 'I was spared all that, I was so lucky. Surprisingly, there wasn't any pain after the operation.'

The use of the robot, called the da Vinci surgical system, has allowed heart surgeons here to perform heart bypasses, repair heart valves and remove chest tumours in a minimally invasive way.

So far, they have carried out operations on 15 patients, including Mr Dragon. Mount Elizabeth Hospital has done a handful of robotic heart procedures too.

As robotic heart procedures are still new, doctors operate only on patients whose conditions are not complicated, and who agree to the procedures.

Mr Dragon recalled making the decision: 'At first I was puzzled, and asked my doctor: 'How can the robot do the operation?'

'But after he said he controls it, and that he had operated on four patients successfully, I was reassured.'

The NHC started a three-year programme in 2006 to evaluate robotic heart surgery, funded by $1.5 million from its parent group, Singapore Health Services.

The trial will be considered successful if the results are 'at least equivalent to conventional procedures', said Associate Professor Koh Tian Hai, the NHC's medical director.

The robotic procedure is meant to result in less pain, less blood loss and faster recovery for patients, said Dr C. Sivathasan, who is leading the robotic heart surgery programme.

Studies in the United States show that most patients are discharged two to three days after the operation, whereas normal bypass patients usually stay six or seven days in hospital.

Most patients here are discharged after four to six days, as doctors want to be careful, Dr Sivathasan said.

In conventional bypass surgery, surgeons need to open up the chest to reach the heart.

They hook up the patient to a heart-lung machine, which takes over the functions of those organs, and stop the heart.

They then attach a vein, removed earlier from the patient's thigh or chest, to the heart arteries to create a bypass that re-channels blood away from blockages.

In a robotic procedure, surgeons no longer need to cut open the chest because the robot's 'arms' can do the job within the chest, entering the body through small cuts.

Seated at a console, the main surgeon controls the robotic arms to get the work done.

For now, the NHC charges the same fee for robotic procedures as conventional operations, though each robotic procedure costs from $2,500 to $5,000 more. A normal bypass there costs a patient staying in a private ward about $24,400.

The robot has also been used for prostate surgery here since 2003.

The NHC marks its 10th anniversary this year with a dinner tomorrow.

Heart facts

Why it matters 
Advances in heart treatment affect a large number of people in Singapore. Heart disease is the No. 2 killer after cancer, accounting for almost 23 per cent of deaths here.

Who has bypass surgery?
Surgeons perform about 4,600 open-heart operations - mostly bypass surgery - in Singapore each year.

What it costs 
A patient in a private ward pays about $24,400 and stays in hospital for about nine days after open-heart bypass surgery at the National Heart Centre.

For now, robotic-assisted surgery patients pay the same, though the heart centre says their operations cost $2,500 to $5,000 more than normal bypass surgery.


Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.