Robotic mitral surgery at East Carolina University: a 6 year experience

Rodríguez, Evelio; Kypson, Alan P.; Moten, Simon; Nifong, L. Wiley; Chitwood, W. Randolph

doi:10.1002/rcs.80

Cited by 52 publications

(18 citation statements)

References 15 publications

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“…The robotic system is now frequently applied to mitral valve surgery that customarily proceeds through a small thoracotomy, and robot-assisted totally endoscopic MVP has recently become popular. 26) Suri et al evaluated the postoperative quality-of-life indices among asymptomatic or minimally symptomatic patients after undergoing isolated MVP for mitral valve regurgitation and concluded that those who were treated using robot-assisted MVP returned to work slightly sooner than those who were treated using a conventional transsternotomy procedure. 27) Cohn et al reported that a minimally invasive approach was associated with a reduced need for red blood cell transfusion, greater patient satisfaction, and a 20% reduction in costs compared with the conventional approach.…”

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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Section: Mitral Valve Surgerymentioning

confidence: 99%

Robot-Assisted Cardiac Surgery

Ishikawa

Watanabe

2015

ATCS

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“…Since these initial pioneering reports, several other groups have demonstrated robotic mitral valve repair to be a safe procedure that can be performed with reasonable cardiopulmonary bypass (89-182 min) and aortic cross-clamp times (58-146 min) [38,[40][41][42][43][44][45][46]. Morbidity is comparable, if not better when compared to repairs performed via standard sternotomy, although the advantages are not apparent when compared with mini-thoracotomy incisions.…”

Section: Robotic Mitral Valve Surgerymentioning

confidence: 90%

Minimally invasive robotic mitral valve surgery

Atluri

Woo

2011

Expert Review of Medical Devices

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Over the past two decades, significant advances have been made in mitral valve surgery. Cardiac surgeons have successfully repaired degenerative and ischemic regurgitant mitral valves via a traditional midline sternotomy. In recent years, alternate incisions have yielded minimally invasive approaches to the mitral valve. Technological advances have made robotically assisted minimally invasive mitral valve surgery feasible. Decreased pain, more rapid return to work, diminished blood loss and reduced length of hospitalization have been witnessed following robotic mitral valve surgery when compared with a traditional sternotomy. Equivalent long-term mortality and freedom from recurrent mitral regurgitation are evident between mitral valve repair performed via a traditional sternotomy and minimally invasive and robotic techniques. As a result, an increasing number of patients and referring cardiologists are seeking minimally invasive approaches to mitral valve surgery.

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“…33 There was one intraoperative death with no devicerelated complications. The reoperation rate was 2.5%.…”

Section: Cardiac Surgerymentioning

confidence: 98%

Robotic Technology in Surgery: Current Status in 2008

Murphy

Hall

Tong

et al. 2008

ANZ Journal of Surgery

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There is increasing patient and surgeon interest in robotic-assisted surgery, particularly with the proliferation of da Vinci surgical systems (Intuitive Surgical, Sunnyvale, CA, USA) throughout the world. There is much debate over the usefulness and cost-effectiveness of these systems. The currently available robotic surgical technology is described. Published data relating to the da Vinci system are reviewed and the current status of surgical robotics within Australia and New Zealand is assessed. The first da Vinci system in Australia and New Zealand was installed in 2003. Four systems had been installed by 2006 and seven systems are currently in use. Most of these are based in private hospitals. Technical advantages of this system include 3-D vision, enhanced dexterity and improved ergonomics when compared with standard laparoscopic surgery. Most procedures currently carried out are urological, with cardiac, gynaecological and general surgeons also using this system. The number of patients undergoing robotic-assisted surgery in Australia and New Zealand has increased fivefold in the past 4 years. The most common procedure carried out is robotic-assisted laparoscopic radical prostatectomy. Published data suggest that robotic-assisted surgery is feasible and safe although the installation and recurring costs remain high. There is increasing acceptance of robotic-assisted surgery, especially for urological procedures. The da Vinci surgical system is becoming more widely available in Australia and New Zealand. Other surgical specialties will probably use this technology. Significant costs are associated with robotic technology and it is not yet widely available to public patients.

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Robotic mitral surgery at East Carolina University: a 6 year experience

Abstract: Robotic MV repair operations are safe with excellent early results. Follow-up studies are needed to determine repair longevity. We must continue to improve the current technology in order to develop the next generation of tools that will facilitate robotic MV repairs.

Cited by 52 publications

References 15 publications

Robot-Assisted Cardiac Surgery

Robot-Assisted Cardiac Surgery

Minimally invasive robotic mitral valve surgery

Robotic Technology in Surgery: Current Status in 2008

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