Robot-assisted coronary surgery: A narrative review on the available data

The robot-based approach has been the most significant advancement in minimally invasive surgery over the past decade. Robotic coronary heart surgery represents half of the total cases of robotics-based cardiac surgery. Since 1998, it has emerged as a revolutionary approach to standard coronary surgery. However, despite its promising beginning, there has been a growing interest in the application of robotics in surgical fields other than cardiac surgery, such as urology and general surgery. In various waves of enthusiasm, single pioneers or visionary cardiac surgeons have tried to extend robotic surgery to different heart procedures, but they still struggled to practice it as a routine approach. Over the last 20 years, robotic platforms have gained importance in minimally invasive heart surgery, with proven safety and efficacy. However, despite its feasibility, safety, and efficacy, less than 0.5%–1.0% of coronary artery bypass grafting procedures are performed using a robot-assisted setup. We believe that in cardiac surgery, the time is ripe to open up new surgical strategies that are increasingly devoted to robotics, hybrid, and augmented-reality-based assistance. With this in mind, we wish to propose an excursus on the state of the art of coronary robotic surgery, its promising results, and its possible future perspectives, with a focus on the most recent achievements. This narrative minireview addresses, therefore, experiences and all aspects related to such a technique, with particular attention gained in robotic coronary revascularization, to the anaesthesiologic as well as surgical aspects, on the learning curve, patient outcome, and related costs, wishing to enlarge the portfolio of the younger generation of cardiac surgeons. In effect, according to the literature data, we are confident that robotic heart surgery is burgeoning, and the new generation of cardiac surgeons must face a gorgeous future if we invest in training and technology.