Robotic cardiac surgery: Present and future applications

Abstract

THE TREND IN cardiac surgery is to minimize patient trauma while reducing the incidence of perioperative morbidity and mortality. Minimally invasive techniques have been introduced to fulfill such expectations. In coronary artery surgery, the use of smaller surgical incisions and avoidance of cardiopulmonary bypass (CPB) are becoming standard practices. 1 Calafiore AM Di Giammarco G Teodori G et al. Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass. Ann Thorac Surg. 1996; 61: 1658-1665 Abstract Full Text PDF PubMed Scopus (563) Google Scholar , 2 Buffolo E de Andrade JCS Branco JNR et al. Coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg. 1996; 61: 63-66 Abstract Full Text PDF PubMed Scopus (553) Google Scholar , 3 Benetti FJ Naselli G Wood M Geffner L Direct myocardial revascularization without extracorporeal circulation: Experience in 700 patients. Chest. 1991; 100: 312-316 Crossref PubMed Scopus (541) Google Scholar Advancements in surgical instrumentation have increased interest in endoscopic cardiac surgery. 4 Chitwood WR Editorial: Endoscopic robotic coronary surgery—is this fact or fantasy?. J Thorac Cardiovasc Surg. 1999; 118: 1-3 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , 5 Mack M Acuff T Yong P et al. Minimally invasive thoracoscopically assisted coronary artery bypass surgery. Eur J Cardiothorac Surg. 1997; 12: 20-24 Crossref PubMed Scopus (37) Google Scholar , 6 Mohr FW Falk V Diegeler A et al. Minimally invasive Port-Access mitral valve surgery. J Thorac Cardiovasc Surg. 1998; 115: 567-576 Abstract Full Text Full Text PDF PubMed Scopus (347) Google Scholar Despite some difficulties that must still be overcome, the development of precise and intelligent robotic-enhanced instruments has reached the point where it has become possible to do cardiac surgical procedures through ports that cause minimal injury. 7 Carpentier A Loulmet D Aupecle B et al. Computer-assisted cardiac surgery. Lancet. 1999; 353: 379-380 Abstract Full Text Full Text PDF PubMed Scopus (88) Google Scholar , 8 Mohr FW Falk V Diegeler A Autschbach R Computer-enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg. 1999; 117: 1212-1215 Abstract Full Text Full Text PDF PubMed Scopus (153) Google Scholar