Feasibility of robotic‐assisted atrial septal defect repair in a 6‐year‐old patient

Abstract

Background The feasibility, safety and advantages of minimally invasive or robotic repair of atrial septal defect (ASD) in adults were reported previously. However, there is limited data for the application of these systems in paediatric patients. Although current robotic systems still have large instruments for surgical repair in children, some appropriate patients may benefit from this technology. Method A 6‐year‐old child with ASD underwent robotic assistant repair via Da‐Vinci Robotic Systems. Venous cannulation was achieved by internal jugular and femoral veins (10F–14F) and arterial cannulation was performed via femoral artery under transesophageal echocardiography (TEE) guidance (10F). A 3 cm incision was made in the right fourth intercostal space, used for working and the camera port in the same time. The ports were placed considering not to damage the potential developing breast tissue. After the port implantation (8F) and cardiac arrest, the ASD repair was completed with primary closure technique. Result The perioperative period was uneventful and the patient was discharged from hospital 5 days after surgery. Conclusion ASD closure with robotic assistant was achieved in a large enough sized paediatric patient. With the development of thinner and shorter robotic arms, it will be possible to use robotic assistance more common during the repair of congenital heart diseases.

Intermediate-Term Outcomes of Totally Endoscopic Atrial Septal Defect Repair on Beating Heart in Small Children

“…However, there are very few reports on the application of minimally invasive approaches in this population, namely, minithoracotomy, [2][3][4] midaxillary approach, 5 and 3 reports on totally endoscopic surgery. [6][7][8] The risk of femoral arterial (FA) complications (compartment syndrome, iliac-femoral artery stenosis or obstruction) and the difficulty of endoscopic manipulation in a narrow surgical field are reasons for the limited use of totally endoscopic surgery in small children. Smaller FA size (due to low weight or young age) increases the risk of FA complications.…”

Cardiac Patch Transplantation Instruments for Robotic Minimally Invasive Cardiac Surgery: Initial Proof-of-concept Designs and Surgery in a Porcine Cadaver

“…With the advancement of minimally invasive robotic cardiothoracic surgery ( Torregrossa and Balkhy, 2020 ; Güllü et al, 2021 ), it is increasingly pertinent to develop feasible, cost-effective, synergistic instrument-control systems ( Trevis et al, 2020 ). Current surgical robots established in clinical use, including da Vinci ® Surgical Systems (Intuitive Surgical Inc., Sunnyvale, CA, United States), have shown that a master-slave (semi-automated) robotic system can perform robotic surgery on humans, resulting in new ways to perform challenging cardiac surgery ( Güllü et al, 2021 ) and potentially improving established operations ( Torregrossa and Balkhy, 2020 ). However, robots like the da Vinci are currently expensive—one Sydney hospital recently reported the implementation cost alone for the da Vinci Xi was $4.4 million AUD (approximately $3.2 million USD) ( McBride et al, 2021 )—which may limit widespread implementation ( Crew, 2020 ).…”

A World-First Surgical Instrument for Minimally Invasive Robotically-Enabled Transplantation of Heart Patches for Myocardial Regeneration: A Brief Research Report

“…Since the first reports of robotic minimally invasive cardiac surgery (1), there has been increasing attention given to the role of minimally invasive robotics in cardiothoracic surgery (2)(3)(4)(5)(6). Meanwhile, tissue engineers have been making gains toward regenerating the myocardium (7)(8)(9).…”