Remote miracle: Robotics surgery becoming more popular in cardiac surgery

Debi Lemon of Dallas has ran two half marathons, two mud runs and a handful of 5k's, and could quite possibly be considered the perfect picture of health.

But no race could prepare the wife and mother of two for the challenge she overcame with the help of a little modern technology.

"I knew I had valve issues, I'd get palpitations doing different things," said Lemon, 43. "But this was a crazy freak thing that just took me down in the break room."

Ironically, Lemon suddenly collapsed on the morning of Jan. 9 at work, not while running. According to Lemon, a coworker immediately yelled for someone to call 911. Another fellow employee soon started performing CPR on Lemon, while the rest of the office prayed for her survival.

Lemon was transported to a nearby hospital, where a cardiac catheterization revealed that she had a congenital birth defect called a left anterior descending, or anomalous coronary artery. Simply put, the artery ran directly through her heart's ventricles instead of around it. The heart muscle had been continuously squeezing the artery, causing Lemon to collapse and, ultimately, require bypass surgery.

According to a study by the Division of Cardiovascular Medicine and Surgery at the University of Massachusetts Medical Center, more than 260 cases of this rare condition have been reported since it was first identified in 1908,. The incidence has been estimated as 1 per 300,000 live births, with only five to 15 percent surviving to adulthood.

Considering most of these defects are found in children, Lemon's condition was something Dr. Rob Smith a cardiothoracic surgeon at the Heart Hospital Baylor Plano called, "a very rare finding," and was like, "sitting on a ticking time bomb."

Lemon already knew her condition was a rare one when the cardiologist who originally examined her said he had never seen this type of condition before in the 32 years he had been practicing medicine. It wasn't long after doctors discovered her anomaly that they rushed her to the Heart Hospital, where she said Smith relieved her of some worry.

"The first time he came in he gave me two options, robotics or crack [my] chest open," Lemon said. "Of course, I was praying for robotic surgery. I didn't even think there was an option. The whole thing was crazy, I've never had surgery in my life."

Unlike traditional, more invasive cardiac and thoracic surgeries, robotic-assisted cardiac and thoracic surgery is less invasive and does not require spreading the chest. The surgeon operates through several keyhole incisions, no longer than 1 to 2 centimeters, along the side of the chest. The robotic arms of the da Vinci Surgical System operate within these ports, with the surgeon in full control of their actions throughout the procedure.

The robotic instruments greatly increase the surgeon's precision, range of motion and ability to see the surgical field, thus advancing their technique and enhancing their capability in performing complex cardiac and thoracic procedures, Smith said.

While the da Vinci robot, which costs about $2 million, has made its mark in the world of surgery over the past four years, Smith said he believes robotics will continue to evolve and advance exponentially over the next decade.

"Minimal invasive surgery is becoming the norm; it mimics my hand motions and actually takes a lot of the defects out of my own hand rotations," he said. "[However], most residents aren't even exposed to this stuff at all [in medical school. It won't become the norm until it's become part of the normal training paradigm."

Three hours and three small incisions later, Lemon's spirits -- and her artery -- were right where Smith wanted them to be. Two days after the procedure, she was ready to go home.

"It's amazing," said Michelle Wills, a surgical technician at the Heart Hospital. "It's more amazing when you see the doctors that you are working for acting like a kid in a candy store with these new advances, and I'm happy to be a part of it. And it's so much better for the patient, too."

On April 6, Lemon and her family were invited to be the "Legend of the Night" by the Heart Hospital and the Texas Legends. The basketball team, and its corporate sponsor, chose Lemon to be honored and let her share her remarkable story with the community.

Even more remarkable is the fact that Lemon has not had to stop doing what she loves, and is already planning to participate another half marathon and the American Heart Association walk this fall.

"[Smith] told me up front I should be able to live a normal life and get back to what I did before," Lemon said. "I can't tell you how many times I cried myself to sleep thinking what if this happened anywhere else, like in car or something, what could have happened."

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