Successful Intracardiac Robotic Surgery Initial Results from Japan

OBJECTIVE: : The purpose of this study is to report our 2-year experience of performing endoscopic intracardiac procedures using the da Vinci Surgical System. Our teams at Kanazawa University and Tokyo Medical University groups began using the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA) in 2005. This series represents the first Japanese application of robotic technology for totally endoscopic open-heart surgery. METHODS: : From January 2008 to February 2009, 10 patients (mean age: 46.8 ± 16.3 years, 70% women) underwent endoscopic atrial septal defect closure and resection of the left atrial myxoma using the da Vinci Surgical System and peripheral cardiopulmonary bypass technique. Of the 10 patients, nine were classified as New York Heart Association class II and 1 patient exhibited atrial arrhythmias. In addition, two patients required mitral valve plasty (n = 2) and tricuspid annuloplasty (n = 1). RESULTS: : Mean da Vinci Surgical System working time was 140.7 ± 57.4 minutes. Mean cardiopulmonary bypass and aortic cross clamp times were 103.1 ± 37.1 and 30.0 ± 16.9 minutes, respectively. There were no conversions to sternotomy or small thoracotomy. There were no hospital deaths. Mean intensive care unit and hospital stays were 1 day and 3.1 ± 0.3 days, respectively. All patients appreciated the cosmetic result and fast recovery. CONCLUSIONS: : Closed-chest atrial septal defect closure and myxoma resection performed using robotic techniques achieved excellent results and rapid postoperative recovery and provided an attractive cosmetic advantage over median sternotomy.