Robotically Enhanced Cardiac Surgery

Summary: Background: The introduction of computer-enhanced instrumentation systems in cardiac surgery helped to overcome some of the limitations of conventional endoscopic instruments. With the aid of telemanipulation systems (so-called robots), totally endoscopic coronary artery bypass grafting (TECAB), closure of atrial septal defects and minimally invasive mitral valve repair have been performed successfully. Very precise intrathoracic operations including coronary artery bypass grafting on the beating heart through three or four intercostal ports have become reality.Methods: The current literature of this field was evaluated. After training in the laboratory, a robotic coronary artery surgery program was implemented at our department. Our first experience with this method is reported.Results: Robotically enhanced techniques are only suitable for selected patients without significant comorbidity. Operation times at present are longer than for conventional procedures and conversion to standard techniques due to technical or anatomical difficulties are frequently necessary. A robotic coronary artery surgery program was installed at our institution in April 2001. Using a stepwise approach, the first TECAB operation was performed successfully in October 2001.Conclusions: Learning curves seem to be steep and safe implementation of the program could be demonstrated.