First-in-Human Automated Endovascular Aortic Repair With the Novel Endovascular Surgical Robot

Abstract

Background Endovascular interventional robots have influenced the practice of vascular surgery. However, most of them remain at a low level of automation and cannot complete the whole process of endovascular surgeries automatically. Materials and Methods Two patients with thoracic and abdominal aortic aneurysm respectively confirmed by computed tomography angiography were enrolled in this study. Both patients were performed automated endovascular aortic repair with the novel endovascular surgical robot. We use the image processing software to generate preoperative planning pathways and lists of surgical steps and the endovascular surgical robot is programmed to execute the list automatically. The operation time, blood loss, total contrast volume, fluoroscopy time, and radiation exposure were measured during the operations. Technical success was defined as completion of surgeries without extra manual measures. The patients were followed up to six months after procedures. Results A 100% technical success rate was achieved in two operations. No adverse clinical effects associated with the endovascular robotic system were reported. Both patients had no documented in-hospital and six-month major adverse cardiac events. After surgeries, all patients were discharged within 72 hours. The surgeon radiation exposure was 96.5% lower than that at the procedure table and the other indices were in line with those reported in published literature. Conclusions The novel endovascular surgical robot can perform automated TEVAR and EVAR surgeries with acceptable accuracy and safety to provide standardized therapies, reduce empirical interference of surgeons and reduce workload of surgeons.