Commentary: Robotic surgical aortic valve replacement: An evolving option

Totally Endoscopic Robot-Assisted Aortic Valve Replacement and Complex Mitral Valve Repair: The Lateral Approach

“…The advantages of our lateral approach were previously described. 6 Our technique promoted postoperative pain reduction by avoiding rib spreading in combination with cryoablation nerve block, which is associated with significant reductions in pain scores and lower request for pain medication. 7 The use of V-loc sutures eliminated knot tying to maximize efficiency within the limited working space.…”

Robotic Surgery for Triple Valve Insufficiency: A Case Report

“…3,4 We found reports of robotic AV replacement via a lateral approach using a conventional prosthesis. 5,6 Wong et al reported simultaneous surgery for AV replacement and MV repair via a lateral approach. 7 They stressed the importance of the lateral approach for the same reason that we shifted the camera port lateral and cranial to the standard position, which is used in our standard robotic MV surgery.…”

The Impact of Biomedical Engineering on the Development of Minimally Invasive Cardio-Thoracic Surgery

“…Although there are no exact figures, MICS for aortic and mitral valve interventions and their transcutaneous equivalents are commonly conducted in most cardiac surgical centers. The use of a robotic slave in aortic valve replacement and CABG is rare, but its use in mitral surgery is common [22][23][24]. Thanks to the availability of transcutaneous solutions, patients with an unfavorable benefit-risk profile for valve surgery can be treated.…”

“…In other words, working with slaves, robots, imaging, and navigation assistance and handling the special MICS tools requires specialized training to master a learning curve [22][23][24]. Today, the manufacturer is required to provide adequate training and educational materials, but it is the surgeon's responsibility to reach the proficiency level and to maintain experience either by performing a sufficient number of cases or by means of training in simulators.…”

“…It is generally accepted that MICS for mitral valve surgery and TECAB has a rather steep learning curve [23][24][25]. The frontrunners in the field hint that proper selection and a time-consuming process of training are mandatory, but fail to describe how it should be conducted.…”