Patient body image, self-esteem, and cosmetic results of minimally invasive robotic cardiac surgery

İyigün, Taner; Kaya, Mehmet; Gülbeyaz, Sevil Özgül; Fıstikçı, Nurhan; Uyanık, Gözde; Yılmaz, Bilge; Onan, Burak; Erkanlı, Korhan

doi:10.1016/j.ijsu.2017.01.105

Cited by 34 publications

(46 citation statements)

References 8 publications

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“…Cross clamping time for an ASD closure is about 15-20 min, whereas it is about 60 min for MVR or PAPVC repair. We believe that these times are longer, but they are acceptable for minimally invasive procedures (1)(2)(3)22).…”

Section: Discussionmentioning

confidence: 99%

“…The dynamic robotic atrial retractor and three‐dimensional endoscopic visualization greatly enhance the exposure of intracardiac anatomy. Skin incisions are very limited, bleeding is minimal, and postoperative return to daily life is quicker .…”

Section: Discussionmentioning

confidence: 99%

“…Robotic cardiac surgery has proved its feasibility and safety in the adult population (1)(2)(3)(4)(5). However, there is still limited data about the application of robotic cardiac surgery in children (6)(7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

“…Totally endoscopic robotic surgery has proved its efficacy and safety in adult cardiac procedures since 2000. Previous studies have reported the feasibility of some cardiac procedures using robotic surgical systems, including mitral valve repair or replacement, coronary artery bypass grafting, repair of atrial septal defects (ASD), and partial anomalous pulmonary venous connections (PAPVC) . The DaVinci surgical system is indicated for adult and pediatric use.…”

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confidence: 99%

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Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

et al. 2018

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Robotic surgery for intracardiac pathologies in children is relatively uncommon. This study presents our initial experience with robotic-assisted cardiac surgery in children. We also present the feasibility and safety of robotic surgery in children. From May 2013 to June 2018, 30 children underwent totally endoscopic robotic atrial septal defect closure (n = 22), right-sided (n = 5) or left-sided (n = 1) partial anomalous pulmonary venous connection repair, tricuspid valve annuloplasty (n = 4), and mitral valve replacement (n = 2, due to Barlow and rheumatic diseases). The mean age of the patients was 16.1 ± 1.1 years (range, 13-17) and the mean weight was 56.7 ± 0.1 kg (range, 42-77). Associated anomalies included left persistent superior vena cava (n = 2) and the absence of innominate vein (n = 1). All procedures were completed uneventfully. Operation time was 4.1 ± 0.6 h. No patient was converted to thoracotomy or sternotomy. Cardiopulmonary bypass and aortic clamping times were 90.6 ± 28.0 (range, 45-136) and 48.6 ± 24.9 (range, 15-94) min, respectively. The mean ventilation time was 3.7 ± 1.2 h and hospital stay time was 3.3 ± 0.7 days. No right phrenic nerve injury, hemorrhage, or blood transfusion were noted. One patient had postoperative pneumothorax, and 1 had supraventricular arrhythmia. Follow-up was a mean of 1.7 years (range, 1-52 months). Patients were healthy and no residual intracardiac defect was observed on echocardiography examinations. There was no operative or follow-up mortality. Robotically assisted cardiac surgery is a feasible and safe approach in selected pediatric patients. In the future, new generation robotic devices may offer an alternative surgical approach in cardiac surgery for younger children with lower body weight.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

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“…Robotic‐assisted cardiac surgery has become a commonly used minimally invasive approach for mitral valve disease and atrial septal defects over the last two decades 1‐11 . Totally endoscopic robotic atrial septal defect (ASD) repair remains a highly complex procedure, which requires experience with several nonroutine operative steps, such as airway management and set‐up.…”

Section: Introductionmentioning

confidence: 99%

Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

et al. 2020

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Objectives This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single‐lumen (SL) endotracheal tube intubation. Methods Between 2013 and 2017, 132 patients underwent robotically‐assisted atrial septal defect closure. A retrospective analysis was performed of 23 patients (11 males, mean age 30.9 ± 5 years) who underwent robotic surgery with double‐lumen (DL) endotracheal tube intubation (group 1) compared with 109 patients (57 males, mean age 32.4 ± 7.5 years) undergoing the same procedure with SL endotracheal intubation (group 2). The patient groups were compared in terms of demographic characteristics, operative data, and complications. The technical feasibility of the robotic procedure without lung isolation was evaluated. Results There were no mortality, intraoperative complication, and conversion. Mean total anesthesia time was significantly decreased in the SL intubation group (238.3 ± 22.4 vs 227.2 ± 21.2 minutes; P = .025). First‐pass intubation success was significantly higher in the SL intubation group (17 [73.9%] vs 98 [89.9%] patients; P = .032). Mean ventilation time (10.9 ± 5.3 hours), intensive care unit stay (16.8 ± 10.1 hours), and the length of hospital stay (3.8 ± 1.2 days) was significantly decreased in patients with SL tube (P < .05). Unilateral reexpansion pulmonary edema was observed in five (21.7%) patients with DL tube, whereas no patient with SL tube had this complication. Conclusions SL endotracheal tube intubation without lung isolation is a feasible and safe airway alternative in robotic cardiac procedures. This approach resulted in shorter anesthesia time, ventilation time and the length of hospital stay. Port placement and robotic set‐up can be uneventfully performed without lung isolation.

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Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

et al. 2020

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Background: Robot-assisted surgery (RAS) has potential panspecialty surgical benefits. High-quality evidence for widespread implementation is lacking. This systematic review aimed to assess the RAS evidence base for the quality of randomized evidence on safety and effectiveness, specialty 'clustering', and outcomes for RAS research. Methods: A systematic review was undertaken according to PRISMA guidelines. All pathologies and procedures utilizing RAS were included. Studies were limited to RCTs, the English language and publication within the last decade. The main outcomes selected for the review design were safety and efficacy, and study purpose. Secondary outcomes were study characteristics, funding and governance. Results: Searches identified 7142 titles, from which 183 RCTs were identified for data extraction. The commonest specialty was urology (35⋅0 per cent). There were just 76 unique study populations, indicating significant overlap of publications; 103 principal studies were assessed further. Only 64⋅1 per cent of studies reported a primary outcome measure, with 29⋅1 per cent matching their registration/protocol. Safety was assessed in 68⋅9 per cent of trials; operative complications were the commonest measure. Forty-eight per cent of trials reported no significant difference in safety between RAS and comparator, and 11 per cent reported RAS to be superior. Efficacy or effectiveness was assessed in 80⋅6 per cent of trials; 43 per cent of trials showed no difference between RAS and comparator, and 24 per cent reported that RAS was superior. Funding was declared in 47⋅6 per cent of trials. Conclusion: The evidence base for RAS is of limited quality and variable transparency in reporting. No patterns of harm to patients were identified. RAS has potential to be beneficial, but requires continued high-quality evaluation.

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Patient body image, self-esteem, and cosmetic results of minimally invasive robotic cardiac surgery

Abstract: The results of this study clearly demonstrated that a minimally invasive approach using robotic-assisted surgery has advantages in terms of body image, self-esteem, and cosmetic outcomes over the conventional approach in patients undergoing cardiac surgery.

Cited by 34 publications

References 8 publications

Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

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