Robotic mitral valve surgery: A United States multicenter trial

Nifong, L. Wiley; Chitwood, W. Randolph; Pappas, Patroklos; Smith, Craig R.; Argenziano, Michael; Starnes, Vaughn A.; Shah, Pravin M.

doi:10.1016/j.jtcvs.2004.07.050

Cited by 229 publications

(120 citation statements)

References 21 publications

(32 reference statements)

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“…Also, technical feasibility and safety were both significantly influenced by the surgical team and center experience. The problem with the learning curve needs to be resolved before a definite [16][17][18]. The use of robot techniques is new in the field of thyroid surgery.…”

Section: Discussionmentioning

confidence: 99%

Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study

et al. 2010

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Objectives Robotic thyroidectomy and lymph node dissection is rapidly emerging as an alternative to conventional endoscopic thyroidectomy for thyroid carcinoma. Robot techniques incorporate the advantages of endoscopic procedures while overcoming some of the problems. We present the largest multi-institution clinical study of robotic thyroidectomy for thyroid carcinomas. The robotic thyroidectomy involved gasless transaxillary approach using the da Vinci surgical robot system. Methods We reviewed a database of 1,043 consecutive patients with low-risk differentiated thyroid carcinoma who underwent robotic thyroidectomy between October 2007 and August 2009. Operations were performed by five surgeons at four academic centers. We analyzed perioperative, clinical, and pathological data. Results The study involved 71 men and 972 women, with a mean age of 39 (range, 15-70) years. All operations were performed successfully without any need for conventional open or endoscopic conversion. There were 366 total thyroidectomies and 677 subtotal thyroidectomies with cervical lymph node dissection. The mean overall operation time and console time were 132.4 and 63.9 min, respectively. There were ten (1%) major postoperative morbidities. The mean tumor size was 0.8 (range, 0.1-6.0) cm, and the mean number of retrieved central lymph nodes was 5.1 ± 3.8 (range, 0-26). The mean postoperative hospital stay was 2.9 (range, 1-8) days. Conclusions Robotic thyroidectomy using gasless transaxillary method was feasible, safe, and provided good outcomes for patients with differentiated thyroid carcinoma. Robotic technology overcame some technical limitations associated with conventional endoscopy.

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Section: Discussionmentioning

confidence: 99%

Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study

et al. 2010

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“…23) Two subsequent studies demonstrated that robotic mitral valve surgery is safe, the short-term results are excellent, and the mid-term durability is good. 24,25) The FDA approved the da Vinci surgical system for mitral valve surgery and atrial septal defect (ASD) repair in November 2002. Mitral valve surgery was accomplished through the same small thoracotomy incisions as the MICS procedure, since the surgical robot allowed the surgeons to complete complex maneuvers.…”

Section: Mitral Valve Surgerymentioning

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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“…In the USA robotic-assisted mitral valve repair was started by Chitwood and colleagues and obtained FDA approval in December 2002. [38] The original model of the da Vinci System controlled the handle of the atrial septal roof retractor (Cardiovations, Irvine, Calif). The second generation, da Vinci Si HD, had a fourth articulating arm which functioned as a movable left atrial roof retractor placed in the 5th ICS medial to the camera port offering more efficient manipulation of retraction to improve visualization as well as to release retraction during testing the valve.…”

Section: Video-directed Robotic-assisted Mimvsmentioning

confidence: 99%

Minimally Invasive Mitral Valve Surgery: An Update

Alkady¹

2017

IJCTS

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Abstract:Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in-ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.

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Robotic mitral valve surgery: A United States multicenter trial

Cited by 229 publications

References 21 publications

Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study

Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study

Robot-Assisted Cardiac Surgery

Minimally Invasive Mitral Valve Surgery: An Update

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