BONIFACIO GLOBAL CITY, Taguig City — The prospect of undergoing an open bypass operation for patients suffering from severe heart disease may be a terrifying thought, not only because the surgery done is so delicate but the steep costs may be a bigger obstacle and even more terrifying experience.

However, both concerns may soon be addressed as a team from St. Luke’s Medical Center (SLMC) at the Bonifacio Global City in Taguig has successfully performed the first-ever robot-assisted cardiac surgery in the Philippines and in Southeast Asia.

Led by SLMC’s robotic cardiac surgeons, Dr. Ramiro Pablo and Dr. Marvin Martinez, the team performed a robotic minimally invasive direct coronary artery bypass on a 40-year-old male patient with assistance from the West Virginia University’s Heart and Vascular Institute.

Pablo and Martinez are the only doctors in the country certified to do robotic cardiac surgeries.

The two surgeons clarified, thought, that 'robotic' does not mean a robot performs the surgery because they still do the procedure but with the help of the US$2.5-million Da Vinci XI surgical system developed by American biotechnology firm Intuitive Surgical Incorporated.

The Da Vinci system adds four hands to the surgery team: three of them can serve as scalpels, scissors, bovies, or graspers, while the fourth holds a 3D camera providing imagery that Pablo described as “feeling like inside the patient, making the surgeon’s movements very precise and faster.”

“With the assistance of the robot and minimally invasive procedures, we do not need to cut through the breastbone or break the ribs of the patient. There’s no bone damaged, there’s less trauma,” Martinez explained on the other hand.

“Instead we just do a few small incisions, around 3 to 4 centimeters (about the size of a grape) so that we can place the robotic arms inside the patient’s chest,” he added.

With this wonderful development, patients in the Philippines, who in the past have the limited option of going abroad, usually to Japan or the United States, will now have an opportunity (if they want) to undergo 'minimally invasive' cardiac surgeries, which involves making smaller incisions in the chest and allows a faster recovery period.

Doctors Pablo and Martinez predict that in the future, more patients will be requesting robot-assisted cardiac surgery given its benefits compared with the conventional approach.

“In SLMC last year, we did an average of 34 minimum invasive surgeries. With the advent of this technology, we are seeing that the minimum invasive procedures will shift toward robotics,” Pablo said.

For his part, Martinez expects more patients as the procedure is not yet done in the rest of Southeast Asia and they need not go to Japan or the United States anymore.

Meanwhile, SLMC senior vice president and chief marketing officer Virginia Flores disclosed that they are now developing a package to make it more affordable.

“The goal is to get a 15- to 20-percent discount through the package. The cost is definitely higher compared with other surgical procedures because of the technology. But studies from abroad show the cost will be equal because of the recovery,” she said. A conventional coronary artery bypass graft surgery costs around ₱500,000.

“If it is covered by insurance, the insurance covers it up to recovery. With the shorter stay at the ICU and faster recovery, it becomes cost neutral,” Flores added.

The Philippine Health Insurance Corporation (PhilHealth) currently does not cover robot-assisted heart surgeries. PhilHealth’s Z benefit package can cover up to ₱550,000 per year for a conventional heart bypass surgery.