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Robotic assisted bypass is a rapidly growing phenomenon in minimally invasive heart surgery, as coronary surgeries can now be performed by robot arms with the aid of a tiny video camera. In this operation, three pencil-sized ports are standard. Through one port a tiny high-powered, voice-operated camera or endoscope is inserted and held by a robotic arm. Two robotic arms that control the surgical equipment are inserted in the other ports. The physician's role is to maneuver the camera through voice-operated controls and to manipulate the surgical equipment using a hand held joystick. Thus the only surgical cut that a physician directly performs is the initial puncture of the chest.
How is robotic heart surgery being used?
Much of the early work with robotically-assisted heart surgery has been with bypass surgery. So far, this technique has been limited to single bypass grafts in the left anterior descending coronary artery (the LAD). The LAD is located on the front of the heart, and therefore is relatively accessible. It is predicted that with advances in technology, multiple grafts with robotic assistance will be possible, at virtually any location on the heart.
Early efforts have been made at extending robotically assisted surgery to other kinds of heart surgery. Robotic procedures have been successfully performed, for instance, in mitral valve repair, in repairing atrial septal defects (ASD,) and in repairing patent ductus arteriosus (PDA.) It is expected that as experience and technology advance, robotic procedures will be applied to most other forms of heart surgery.
Two robotic surgical systems are currently available, both developed and manufactured in the U.S. However, while both robotic systems have been approved for use in Europe, both remain experimental in the United States. It is not likely they will be approved in the U.S. until randomized clinical trials are completed that convincingly demonstrate their safety and efficacy.
What are the advantages of robotic heart surgery?
The chief advantage of such surgery is that the incisions that are made are tiny, and therefore recovery from surgery is extremely quick. Rapid recovery from cardiac surgery is not only better for the patient, but it is less expensive for society.
What are the disadvantages of robotic heart surgery?
The chief disadvantage at this point is that the technology is new, and (despite early encouraging reports) is still evolving. Its efficacy and safety have not yet been proven sufficiently to allow the FDA to approve it for widespread use.
Another disadvantage is the expense of the robotic systems. They cost between $750,000 and $1,000,000, and it is unlikely that most hospitals will be able to afford purchasing the robotic systems for operations they are performing "just fine" today without the robotic equipment.
The bottom line: it is likely to be several years before robotic heart surgery is widely available.
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Robotic assisted bypass is a rapidly growing phenomenon in minimally invasive heart surgery, as coronary surgeries can now be performed by robot arms with the aid of a tiny video camera. In this operation, three pencil-sized ports are standard. Through one port a tiny high-powered, voice-operated camera or endoscope is inserted and held by a robotic arm. Two robotic arms that control the surgical equipment are inserted in the other ports. The physician's role is to maneuver the camera through voice-operated controls and to manipulate the surgical equipment using a hand held joystick. Thus the only surgical cut that a physician directly performs is the initial puncture of the chest. 
Much of the early work with robotically-assisted heart surgery has been with bypass surgery. So far, this technique has been limited to single bypass grafts in the left anterior descending coronary artery (the LAD). The LAD is located on the front of the heart, and therefore is relatively accessible. It is predicted that with advances in technology, multiple grafts with robotic assistance will be possible, at virtually any location on the heart. 
