Hybrid Coronary Revascularization Using Robotic Totally Endoscopic Surgery: Perioperative Outcomes and 5-Year Results

Bonatti, Johannes; Zimrin, David; Lehr, Eric J.; Vesely, Mark R.; Kon, Zachary N.; Wehman, Brody; Biasi, Andreas R. de; Hofauer, Benedikt; Weidinger, Felix; Schachner, Thomas; Bonaros, Nikolaos; Friedrich, Guy

doi:10.1016/j.athoracsur.2012.05.041

Cited by 74 publications

(59 citation statements)

References 18 publications

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“…14) Bonatti et al described the feasibility and safety of simultaneous hybrid coronary revascularization. 15,16) The approach appeared safe and feasible, particularly with advances in robotic instrumentation, and it may be an evolutionary step to use a hybrid procedure that combines PCI and minimally invasive CAG. …”

Section: Hybrid Proceduresmentioning

confidence: 99%

Robot-Assisted Cardiac Surgery

Ishikawa

Watanabe

2015

ATCS

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The significant advantages of minimizing surgical trauma, such as reduced pain, shorter hospital stays, faster return to normal activities, and improved cosmesis, have resulted in the development of minimally invasive surgery. 1) Until recently, various difficulties associated with endoscopic approaches had stalled similar progress in the field of cardiac surgery. However, robotic technology overcame the difficulties associated with conventional endoscopic surgery and has made possible a new approach to minimally invasive cardiac surgery.The application of robot-assisted coronary surgery ranges from internal mammary artery (IMA) harvesting with handsewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB) either on-or off-pump. The bilateral IMAs can be harvested with the aid of a surgical robot, and then multivessel bypass grafting can follow. Srivastava calls such robot-assisted minimally invasive direct coronary artery bypass grafting (MIDCAB) "ThoraCAB.'' 2) Surgical robots can not only endoscopically harvest the IMA, but they can also anastomose the coronary artery in TECAB.On the other hand, closed-chest cardiopulmonary bypass (CPB) and cardioplegic arrest have stimulated the development of minimally invasive cardiac surgery (MICS) via a small thoracotomy, 3) and this has now become universal, especially to treat valve diseases and congenital structural heart diseases. Endoscopic techniques are also required for MICS, but conventional endoscopic instrumentation lacks the dexterity required for delicate cardiac surgical procedures, and the loss of depth perception caused by twodimensional monitors further increases operative obstacles.Surgical robots have been developed to enhance surgical ability and precision, and to repair structural heart conditions, including mitral valve plasty (MVP), atrial septal defect closure, cardiac tumour resection, ThoraCAB, and TECAB. The most common applications in cardiac surgery are MVP and endoscopic coronary artery bypass grafting (CABG). da Vinci Surgical SystemThe da Vinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA) comprises a surgeon's console, a Robot-Assisted Cardiac SurgeryNorihiko Ishikawa, MD, PhD and Go Watanabe, MD, PhD Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardi...

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Section: Hybrid Proceduresmentioning

confidence: 99%

Robot-Assisted Cardiac Surgery

Ishikawa

Watanabe

2015

ATCS

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“…We have published our TECAB results alone and as combinations of TECAB with PCI in hybrid coronary revascularization (1,2,5). Results appear to meet the standards of standard CABG through sternotomy.…”

Section: Clinical Resultsmentioning

confidence: 92%

Robotic totally endoscopic coronary artery bypass grafting (TECAB)—placement of bilateral internal mammary arteries to the left ventricle

Bonatti

Vento²,

Bonaros

et al. 2016

Ann. Cardiothorac. Surg.

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“…33 Small nonrandomized studies comparing hybrid revascularization to traditional CABG have shown similar short-term results, but long-term outcomes are unknown. 33, 34 An appropriate discussion to have is when revascularization should be attempted in high-risk patients and how highrisk revascularization compares to optimal medical treatment alone. A third treatment arm of optimal medical therapy would have been informative; unfortunately, such a group with sufficient follow-up data could not be identified for this study.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery in High Surgical Risk Patients With Left Main or Three-Vessel Coronary Artery Disease

Nfor¹,

Shetabi²,

Hassan³

et al. 2015

Journal of Patient-Centered Research and Reviews

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Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationNfor T, Shetabi K, Hassan W, Nfor Q, Khitha J, Gupta A, Bajwa T, Allaqaband S. Clinical outcomes after drug-eluting stents versus coronary artery bypass surgery in high surgical risk patients with left main or three-vessel coronary artery disease. J Patient-Centered Res Rev. 2015;2:95-103.

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Hybrid Coronary Revascularization Using Robotic Totally Endoscopic Surgery: Perioperative Outcomes and 5-Year Results

Cited by 74 publications

References 18 publications

Robot-Assisted Cardiac Surgery

Robot-Assisted Cardiac Surgery

Robotic totally endoscopic coronary artery bypass grafting (TECAB)—placement of bilateral internal mammary arteries to the left ventricle

Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery in High Surgical Risk Patients With Left Main or Three-Vessel Coronary Artery Disease

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