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. 2013 Jul-Sep;11(3):296-302.
doi: 10.1590/s1679-45082013000300007.

Robotic surgery in cardiology: a safe and effective procedure

[Article in English, Portuguese]
Robinson Poffo, Alisson Parrilha Toschi, Renato Bastos Pope, Alex Luiz Celullare, Anderson Benício, Claudio Henrique Fischer, Marcelo Luiz Campos Vieira, Alexandre Teruya, Dina Mie Hatanaka, Gabriel Franzin Rusca, Marcia Makdisse

Robotic surgery in cardiology: a safe and effective procedure

[Article in English, Portuguese]
Robinson Poffo et al. Einstein (Sao Paulo). 2013 Jul-Sep.

Abstract
in English, Portuguese

Objective: To evaluate the short and medium-term outcomes of patients undergoing robotic-assisted minimally invasive cardiac surgery.

Methods: From March 2010 to March 2013, 21 patients underwent robotic-assisted cardiac surgery. The procedures performed were: mitral valve repair, mitral valve replacement, surgical correction of atrial fibrillation, surgical correction of atrial septal defect, intracardiac tumor resection, totally endoscopic coronary artery bypass surgery and pericardiectomy.

Results: The mean age was 48.39±18.05 years. The mean cardiopulmonary bypass time was 151.7±99.97 minutes, and the mean aortic cross-clamp time was 109.94±81.34 minutes. The mean duration of intubation was 7.52±15.2 hours, and 16 (76.2%) patients were extubated in the operating room immediately after the procedure. The mean length of intensive care unit stay was 1.67±1.46 days. There were no conversions to sternotomy. There was no in-hospital death or deaths during the medium-term follow-up. Patients mean follow up time was 684±346 days, ranging from 28 to 1096 days.

Conclusion: Robotic-assisted cardiac surgery proved to be feasible, safe and effective and can be applied in the correction of various intra and extracardiac pathologies.

Objetivo:: Avaliar os resultados em curto e médio prazo dos pacientes submetidos à cirurgia cardíaca minimamente invasiva robô-assistida.

Métodos:: De março de 2010 a março de 2013, 21 pacientes foram submetidos à cirurgia cardíaca robô-assistida. Os procedimentos realizados foram: plastia valvar mitral, troca valvar mitral, cirurgia de correção da fibrilação atrial, correção cirúrgica da comunicação interatrial, ressecção de tumor intracardíaco, revascularização do miocárdio totalmente endoscópica e pericardiectomia.

Resultados:: A idade média foi de 48,39±18,05 anos. 0 tempo médio de circulação extracorpórea foi de 151,7±99,97 minutos, e o tempo médio de pinçamento aórtico foi de 109,94±81,34 minutos. 0 tempo médio de intubação orotraqueal foi de 7,52±15,2 horas, sendo que 16 (76,2%) pacientes foram extubados ainda em sala operatória, imediatamente após o procedimento. 0 tempo médio de permanência em unidade de terapia intensiva foi de 1,67±1,46 dias. Não houve conversões para esternotomia. Não houve óbito intra-hospitalar ou mesmo durante o seguimento em médio prazo dos pacientes. A média do tempo de acompanhamento dos pacientes foi de 684±346 dias, variando de 28 dias a 1096 dias.

Conclusão:: A cirurgia cardíaca robô-assistida mostrou-se exequível, segura e efetiva, podendo ser aplicada na correção de diversas patologias intra e extracardíacas.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: none.

Figures

Figure 1
Figure 1. Preoperative markings and sites for the introduction of (1) left atrial retractor; (2) left robotic arm; (3) right robotic arm, (4) working trocar; (5) micro camera. C: transthoracic aortic clamp; MCL: mid-clavicular line; AAL: anterior axillary line; MAL: mid-axillary line
Figure 2
Figure 2. External aspect of the operative field: DaVinci™ robotic system docked to the patient
Figure 3
Figure 3. Arrows indicate the markings for the introduction of trocars for totally endoscopic coronary artery bypass
Figure 4
Figure 4. Kaplan-Meier survival curve of operated patients
See this image and copyright information in PMC

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