History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

Lee, Jeffrey D.; Srivastava, Mukta; Bonatti, Johannes

doi:10.1253/circj.cj-12-0981

Cited by 43 publications

(26 citation statements)

References 38 publications

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“…The current literature shows mortality ranging between 0-1%, as well as low rates of post-operative complications, such as revision for bleeding, conversion to a larger incision, and stroke. Another measure of success, vessel patency, has also been maintained in over 90% of cases (28,29). Furthermore, a decline in conversion rates over the years has been demonstrated (16).…”

Section: Discussionmentioning

confidence: 95%

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The state of robotic cardiac surgery in Europe

Pettinari¹,

Navarra²,

Noirhomme³

et al. 2017

Ann. Cardiothorac. Surg.

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Background: In the past two decades, the introduction of robotic technology has facilitated minimally invasive cardiac surgery, allowing surgeons to operate endoscopically rather than through a median sternotomy. This approach has facilitated procedures for several structural heart conditions, including mitral valve repair, atrial septal defect closure and multivessel minimally invasive coronary artery bypass grafting.In this rapidly evolving field, we review the status of robotic cardiac surgery in Europe with a focus on mitral valve surgery and coronary revascularization. Results: Fourteen papers on coronary surgery were included in the analysis and reported a mortality rate ranging between 0-1%, revision for bleeding between 2-7%, conversion to a larger incision between 2-15%, and patency rate between 92-98%. The number of procedures ranged between 23 and 170 per year. There were only a small number of published reports for robotic mitral valve surgery from European centers.Conclusions: Coronary robotic surgery in Europe has been performed safely and effectively with very few perioperative complications in the last 15 years. On the other hand, mitral surgery has been developed later with increasing applications of this technology only in the last 5-6 years.

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Section: Discussionmentioning

confidence: 95%

“…Whilst robotic cardiac surgery has evolved and its use has spread since its initial introduction, these procedures remain in their primitive stages. It is likely that, for the foreseeable future, robotic cardiac surgery will remain in the hands of committed teams at specialized centers (28). …”

Section: Discussionmentioning

confidence: 99%

The state of robotic cardiac surgery in Europe

Pettinari¹,

Navarra²,

Noirhomme³

et al. 2017

Ann. Cardiothorac. Surg.

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“…Tüm bunlar göz önünde bulundurulduğunda robotik koroner baypas cerrahisi için kontendikasyonlar sol ön inen arterin kalsifi k ve intramural yerleşimli olması, yeni geçirilmiş miyokard enfarktüsü, ileri yaş, toraks boşluğunda anatomik deformite olması, sol ventrikül sistolik fonksiyonlarının ileri derecede bozulmuş olması ve periferik damar hastalığı olarak sayılabilir (7) . Robot yardımıyla internal mammaryan arter greftinin hazırlandığı 200 hastadan oluşan bir seride orta dönem anastomoz açıklık oranları %95'in üzerinde saptanmıştır (8) .…”

Section: Discussionunclassified

Robotically Enhanced Coronary Artery Bypass Surgery via Mini-thoracotomy in Patients with Single Vessel Disease

Bakuy¹,

Gürsoy²,

Gulmaliyev³

et al. 2015

Kosuyolu Heart Journal

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Minimal invaziv endoskopik teknikler günümüzde cerrahi disiplinlerin hemen hepsinde artan sıklıkla uygulama alanı bulmaktadır. Özellikle robot yardımıyla gerçekleştirilen ameliyatlarda üç boyutlu görüntüleme sistemi ve cerrahın el hareketlerini taklit eden laporoskopik kollar vasıtası ile cerrahi kesilerin ve travmanın azaltılması amaçlanmış ve böylece daha az postoperatif ağrı, kan kaybı, hastanede kalış süresi ve normal aktiviteye erken dönüş sağlanmıştır (1). Kalp ve damar cerrahisinde ise robotik teknoloji yardımıyla sıklıkla koroner baypas greftleme ameliyatı ile kapak replasmanı ve onarımı operasyonları yapılmaktadır (2). Bu teknoloji yardımıyla cerrahi prosedürler günümüzde Sağlık Bakanlığına bağlı devlet hastanelerinde de uygulanabilmektedir. Kliniğimizde de tek damar koroner arter hastalarında [sol ön inen arterde (LAD) %70 ve üzeri proksimal lezyon] robot yardımıyla koroner baypas operasyonu gerçekleştirilebilmektedir. OLGU SUNUMU Tek damar hastalığı nedeniyle kliniğimizde koroner arter baypas greftleme ameliyatı planlanan hastalar, robot yardımıyla minimal invaziv operasyon teknikleri ve komplikasyonları hakkında bilgilendirildi. Bu hastalardan bu teknikle ameliyat için onamları alınan altı hastaya Da Vinci S Cerrahi Sistemi (Intuitive Surgical, California, USA) yardımıyla internal mammaryan arter (İMA) hazırlanmasını takiben küçük torakotomiden tekli baypas [single vessel small thoracotomy (SVST)] yapıldı. Olguların anjiyografi k ve operatif bilgileri Tablo 1'de yer almaktadır. Cerrahi Teknik Anestezi Standart anestezi indüksiyonunu takiben hasta çift lümenli endotrakeal tüp ile entübe edilerek tek akciğer ventilasyonu sağlandı. Hastaya eksternal defi brilatör pedi yerleştirildi ÖZET Kalp ve damar cerrahisinde robot yardımıyla yapılan operasyonlar sıklıkla koroner baypas greftleme, kapak replasmanı ve onarımı ameliyatlarıdır. Özellikle tek damar koroner arter hastalığı olan olgularda minimal insizyon ile koroner baypas ameliyatı gerçekleştirilebilir. Biz de bu yazıda kliniğimizde robot yardımıyla atan kalpte koroner baypas yapılmış vakaları sunmayı amaçladık.

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“…Robotic-assisted totally endoscopic cardiac surgery has been performed for more than fifteen years in Europe and United States of America (1)(2)(3). Since the first procedures, there have been extensive discussions regarding its safety, viability and clinical outcomes (4).…”

Section: Introductionmentioning

confidence: 99%

Robotic cardiac surgery in Brazil

Poffo

Toschi

Pope

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in LatinAmerica. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil.Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy.Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term.Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

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History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

Cited by 43 publications

References 38 publications

The state of robotic cardiac surgery in Europe

The state of robotic cardiac surgery in Europe

Robotically Enhanced Coronary Artery Bypass Surgery via Mini-thoracotomy in Patients with Single Vessel Disease

Robotic cardiac surgery in Brazil

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