Early results of totally endoscopic robotic aortic valve replacement: analysis of 4 cases

Abstract

Objective To evaluate the role of totally endoscopic robotic aortic valve replacement in cardiac surgery. Methods Four cases of totally robotic aortic valve replacement (AVR) were conducted from December 2016 to July 2018. All operations were completed with the Da Vinci robot Si™ system (intuitive Surgical, Inc. Sunnyvale, C.A, USA). Patients were male, with a mean age of 42.8 ± 6.2 years (range 32–49). Results AVR was completed with the Da Vinci Si™ system (intuitive Surgical, Inc. Sunnyvale, CA, USA). There was no mortality and no procedure-related morbidity. The mean cardiopulmonary bypass and mean cross-clamp time was 252 ± 13.6 min and 178.8 ± 17.1 min, respectively. The mean ICU time was 78.8 ± 27.1 h, and the mean hospital stay was 15 ± 3.5 d. During a mean follow-up of 3 years and 6 months, the patients returned to normal function, and no heart murmur was found. Compared with the operation, the body image score of the four patients increased after the operation, and the hospital anxiety and depression scale scores decreased, indicating that the patient's condition had been alleviated to a certain extent. Conclusion Totally endoscopic robotic AVR is a feasible and viable choice for patients but requires further improvement for broader use.

Robotic-Assisted Solutions for Invasive Cardiology, Cardiac Surgery and Routine On-Ward Tasks: A Narrative Review

“…In addition, Sun points to the lack of a proper hook to expose the valve, difficulties in suturing the aortic annulus and long knotting time, as well as difficult cooperation with the assistant. However, as he himself notes, this may be due to the team’s limited experience [ 59 ]. In reports on RAVR, the achieved aortic clamping time and CPB time were much longer than in classic surgical aortic valve replacement procedures.…”

“…In reports on RAVR, the achieved aortic clamping time and CPB time were much longer than in classic surgical aortic valve replacement procedures. This has a direct impact on the duration of cardiac ischaemia and the procedure [ 57 , 58 , 59 ]. Therefore, RAVR is not a good choice for patients with contractility disorders of the heart, low left ventricular ejection fraction, and high operative risk.…”

“…However, the benefit of no sternotomy, no complications in wound healing, short hospitalization, quick rehabilitation, and good cosmetic effect may be an interesting alternative for a selected group of patients. The advantage of RAVR over minimally invasive surgical aortic valve replacement may be the enlarged 3D operating field, the use of a mechanical arm with 7 degrees of freedom, the reduction of incision size, and the elimination of hand tremor, which seems to be less important in aortic valve surgery than in coronary surgery [ 59 ]. In our opinion, in order to standardize and disseminate the method, it is necessary to create multi-center large registries of patients with aortic valve disease treated with RAVR.…”

Semiautonomous Robotic Manipulator for Minimally Invasive Aortic Valve Replacement

“…Research in robotic valve replacement started with the use of the Da Vinci surgical system in 2005 [8] and continued in 2010 with the complete excision of diseased native aortic valve leaflets and the accurate placement of a Sorin Perceval artificial valve [9]. Although robotic cardiac surgery has demonstrated several benefits, such as smaller incisions, motion scaling, and enhanced visualization [10], [11], [12], [13], the introduction of the Da Vinci robot into cardiac surgery has been slow, mainly because its grasping solutions are not designed for holding and manipulating the artificial valve [14], [15]. To overcome the abovementioned limitations, dedicated robotic systems were introduced for aortic heart valve surgery, albeit with rigid sheath and limited actuation [16].…”

Validity and reliability of a Thai version of the Body Image Scale among patients with post-coronary artery bypass graft

“…Research on body image has also been conducted in other countries, examining diverse patient populations, including those receiving hemodialysis, undergoing renal transplantation (Rezai et al, 2009 ), dealing with heart failure (Goudarzian et al, 2016 ), and undergoing heart surgery (Lyigun et al, 2017 ). Among patients who have undergone coronary artery bypass grafting (CABG), previous studies have shown that surgical scars on the chest can result in a loss of positive body image if the patients are unable to accept these physical changes (Sun et al, 2022 ). Iyigun et al ( 2017 ) reported that 84% of post-CABG patients experienced a negative perception of body image or a decrease in positive body image due to the presence of surgical scars.…”