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In a landmark achievement for healthcare in Southeast Asia, St. Luke's Medical Center has launched the region's first robotic cardiac surgery program. This historic initiative was made possible through a collaborative effort between St. Luke's multidisciplinary team, led by Drs. Marvin Martinez and Ramiro Pablo, and the expert team from West Virginia University's (WVU) Heart and Vascular Institute, including Dr. Vinay Badhwar, Dr. Lawrence Wei, and physician assistant Herald Fe.

The program debuted with a series of innovative robotic-assisted cardiac procedures, showcasing the transformative potential of this advanced technology. Among the groundbreaking surgeries performed were:

• Robotic MIDCAB (Minimally Invasive Direct Coronary Artery Bypass)
• Robotic bileaflet mitral valve repair for severe mitral regurgitation (MR) due to bileaflet myxomatous disease
• Robotic mitral valve repair for endocarditis, including anterior mitral leaflet perforation
• Robotic adult congenital atrial septal reconstruction using a bovine patch for a patient with a common atrium
• Robotic aortic valve replacement (AVR) for a patient from Papua New Guinea

The first robotic valve surgery—a repair of a severely regurgitant mitral valve in a 40-year-old patient—marked a defining moment in the program's success. With guidance from WVU's Heart and Vascular Institute, the procedure was completed with precision and excellence, underscoring the collaboration's impact.

Dr. Pablo expressed his excitement, saying, "This is a monumental step forward for cardiac care in Southeast Asia. Our partnership with the WVU team has empowered us to provide patients with less invasive, highly precise procedures and faster recoveries."

Dr. Martinez added, "Establishing this robotic cardiac surgery program has been a dream realized through our team's dedication and the invaluable expertise of our WVU partners. This is just the beginning of a new era in cardiac care."

Reflecting on the collaboration, Dr. Badhwar remarked, "Teamwork truly makes the dream work. The exceptional multidisciplinary team at St. Luke's has shown that vision, determination, and collaboration can achieve extraordinary outcomes."

St. Luke's Robotic Cardiac Surgery Program is set to advance care across the region, offering minimally invasive options that reduce pain, recovery time, and the risk of complications. 

The rapid advancement of robotic technology has revolutionized the field of thoracic surgery. At the same time, the technological leap has highlighted a pressing need to bridge the educational gap in the training of thoracic surgery trainees. To address this issue, the Society of Thoracic Surgeons has developed an expert consensus document outlining a framework for a standardized national robotic curriculum.

A recent paper published in The Annals of Thoracic Surgery, authored by the Task Force on Robotic Thoracic Surgery and the Workforce on E-learning and Educational Innovation, has provided expert consensus statements for thoracic surgery training programs. This paper was created following an extensive literature review and expert consensus achieved through a modified Delphi process. It outlines expectations for programs, essential training components, as well as assessment and feedback methods.

Program Expectations

• Standardization: The consensus document advocates for standardized robotic thoracic curricula across all Accreditation Council for Graduate Medical Education-accredited programs.
• Dual Console Training: Trainees should have ample opportunity to practice on dual consoles during most cases to actively participate in the surgical process.
• Bedside Assistance: The presence of a trained bedside assistant during teaching cases is strongly recommended.

Components of Training

• Theoretical & Practical: The curriculum must integrate theoretical and practical learning.
• Pre-Console Training: Online modules on robotic components and hands-on training are mandatory before console surgery.
• VR Simulation: Proficiency in digital/virtual reality simulation modules is a prerequisite for console surgery.
• Wet Lab Training: Mandatory participation in at least one wet lab per year.
• Emergency Conversion: Mandatory to perform with the trainees or OR team at least once a year.

Assessment and Feedback

• Skill Assessment: Utilize objective tools like Global Evaluative Assessment of Robotic Skills to assess technical competency.
• EPA Development: Develop Entrusted Professional Activity for pulmonary resection.
• Performance Review: Regular video review and analysis of robotic performances provide valuable feedback.

By implementing the recommendations outlined in this expert consensus document, thoracic surgery training programs can ensure that trainees are well-prepared to perform complex robotic procedures and contribute to the advancement of thoracic surgery.

"Robotic surgery is rapidly evolving, and it's crucial that our training programs keep pace,” said Samuel Kim, MD, Northwestern Medicine, who chaired the task force that produced the document. "To ensure a skilled workforce capable of meeting the demands of modern thoracic surgery, we must prioritize a standardized curriculum that enhances resident education and bridges any existing educational disparities across training programs. By fostering a comprehensive learning environment that emphasizes both refined technical skills and sound clinical judgment, we can effectively train the next generation of surgical leaders."

Read the Annals article here.

It is with profound sadness that we announce the passing of Dr. Albert Starr, a pioneer in the field of cardiothoracic surgery, who passed away on Dec. 12, 2024, at age 98. Dr. Starr served as the 21st president of The Society of Thoracic Surgeons from 1985 to 1986, leaving an enduring impact on the specialty and the Society.

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Dr. Starr received his medical degree from Columbia University College of Physicians and Surgeons in 1954. After an internship at Johns Hopkins, he completed his general and thoracic surgical residencies at Bellevue and Presbyterian Hospitals in New York City. He was recruited to Oregon in 1957 to head a new heart surgery program at the University of Oregon Medical School, now the Oregon Health & Science University Heart Institute.

His drive for innovation led him to collaborate with engineer Lowell Edwards, which resulted in the development of the Starr-Edwards heart valve—one of the first successful artificial heart valves used in humans. The Starr-Edwards valve revolutionized the treatment of valvular heart disease and is considered one of the most significant advances in cardiac surgery in the 20th century.

Throughout his career, Dr. Starr remained a tireless advocate for the improvement of heart valve surgery. His pioneering work not only advanced surgical techniques but also laid the groundwork for the development of future generations of heart valves. His leadership in cardiothoracic surgery, both in the operating room and in the broader medical community, earned him recognition as a visionary in the field.

Dr. Starr’s tenure as president of The Society of Thoracic Surgeons was marked by his passion for fostering education, research, and collaboration within the Society. He was instrumental in advancing the Society’s mission of improving patient care through the dissemination of knowledge and the promotion of cutting-edge surgical practices.

“The positive forces of technological innovation, entrepreneurial activity, and capital availability will ensure a future of opportunity and growth,” Dr. Starr said in his 1986 presidential address. “The thoracic surgical industry will continue to be a source of great excitement to us and of benefit to our patients.”

Dr. Starr was the 2007 co-recipient of the prestigious Albert Lasker Award for Clinical Medical Research with Alain Carpentier in recognition of their development of prosthetic mitral and aortic valves, which have prolonged and enhanced the lives of millions of people with heart disease.

Beyond his clinical and academic contributions, Dr. Starr was a beloved mentor, guiding countless residents, international fellows and surgeons who would go on to achieve their own successes. His kindness, wisdom, and dedication to improving patient outcomes will continue to inspire those in the field for generations to come.

His legacy in the field of thoracic surgery is immeasurable, and his memory will continue to shape the future of our profession.

Learn more about Dr. Starr here and here.