Feasibility, safety, and efficacy of totally endoscopic coronary artery bypass grafting: Multicenter European experience

Cannière, Didier De; Wimmer‐Greinecker, Gerhard; Cichoń, Romuald; Gulielmos, Vassilios; Praet, Frank Van; Seshadri-Kreaden, Usha; Falk, Volkmar

doi:10.1016/j.jtcvs.2006.06.057

Cited by 121 publications

(78 citation statements)

References 19 publications

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“…One study provided separate data for both the TECAB offpump and robotic MIDCAB groups, and was included for analysis in both groups (10). Eighteen additional studies reported on a mixture of different surgical techniques (18,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53). A summary of the study selection process is presented in the PRISMA chart in Figure 1, and a summary of study characteristics is presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies were excluded from the final analysis due to a mixed dataset for different surgical techniques (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) or use of cardiopulmonary bypass (36)(37)(38)(39)(40)(41), or use of an outdated robotic system other than the da Vinci system (18,34,35). Of the patients who were included for statistical analysis in the selected studies on off-pump TECAB, on-pump TECAB and robotic MIDCAB, the mean age ranged from 58 to 67, and 51-88% of patients were male.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival.Methods: Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB offpump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB).Results: The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group.Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques.Conclusions: A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical followup with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative mortality rates for selected patients at specialized centres. These results should be considered as a useful benchmark for future studies, until further data is reported in the form of randomized trials.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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“…18 Results from a multicenter European study were published in 2007. 19 Between September 1998 and November 2002, a total of 228 patients with CAD were scheduled for TECAB with the da Vinci Surgical System (Intuitive Surgical) at 5 European institutions. Patients underwent TECAB with either an on-pump (group A, n=117) or an off-pump approach (group B, n=111) and were followed up for 6 months.…”

Section: Developments In 2006-2010mentioning

confidence: 99%

History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

Lee

Srivastava

Bonatti³

2012

Circ J

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Robotic totally endoscopic coronary artery bypass (TECAB) is a minimally invasive endoscopic surgical approach using the daVinci robotic telemanipulation system to perform coronary artery bypass grafting on the arrested or beating heart. It is a procedure that can be a useful alternative to the classic open procedure performed through sternotomy. After extensive modeling in cadavers, the first clinical case was performed in June 1998 placing a left internal thoracic artery graft (LITA) to the left anterior descending artery completely robotically on the arrested heart. During the early and late 2000 s, international groups have adopted this evolving technology, which has included iterations such as beating-heart TECAB, use of bilateral ITA grafting and radial artery grafting, as well as 3- and 4-vessel TECAB. TECAB is combined with percutaneous coronary intervention in hybrid procedures. Despite increasing complexity of endoscopic coronary bypass surgery, conversion rates to open bypass surgery have dropped significantly and operative times have decreased. Published major morbidities and mortality rates in arrested- and beating-heart TECAB have been cumulatively in the 0-2% range and are considered well within the expected range for these highly complex surgical procedures. Long-term survival and freedom from major adverse events also meet the standards of open bypass surgery. (Circ J 2012; 76: 2058 - 2065

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“…Introduction of mid-CAB procedures help usher in the era of off-pump CABG, which was heralded as an approach to reduce the risks associated with on-pump CABG, particularly myocardial dysfunction and cerebrovascular complications [12]. Finally, technology has introduced minimally invasive platforms for performing multi-vessel CABG, most recently the introduction of "totally endoscopic" and robotic CABG surgery [13]. However, it should be noted that these "improved techniques" continue to utilize the same conduit selection and comparative trials with objective evidence are lacking.…”

Section: Introductionmentioning

confidence: 99%