APPLICATION OF ROBOTIC TECHNOLOGIES IN CORONARY SURGERY: EXPERIENCE OF ONE CENTRE

Highlights

This article presents our own experience and summarizes the global experience of performing coronary artery bypass surgery using robotic technologies. There are very few articles on this topic, there are no domestic articles at all (as well as no domestic experience), however, this area is the peak of minimally invasive surgery and is quite an advanced and developing area. Studying international experience and highlighting domestic experience will allow us to come to the right decision in each individual case and to develop robotic surgery everywhere in the leading centers of our country.

Background. Coronary artery bypass (CAB) is the most commonly performed surgical procedure in cardiovascular surgery with a constantly evolving minimally invasive approach. Minimally invasive cardiac surgery, including robot-assisted coronary artery bypass surgery, can reduce the intensity of postoperative pain, significantly reduce the incidence of postoperative wound infections and hospital stay. However, the widespread use of robot-assisted interventions in clinical practice is difficult due to a number of drawbacks and requires further study.

Aim. To study the possibilities of robotic technologies in coronary surgery in the conditions of the profile hospital.

Methods. In our clinic (University Clinical Hospital № 1 of Sechenov University) 3 MICSCAB operations were performed in the period from May to July 2024, but the left internal thoracic artery was harvested by robotic instruments using Da Vinci Si system. On analysis, we found that all grafts had satisfactory blood flow and were of sufficient length, patients had fewer complaints of chest pain on follow-up interview, and the operation time lengthened marginally.

Results. In all cases, conversion to median sternotomy and repeat thoracotomy or sternotomy due to bleeding was not required. In the early postoperative period, no arrhythmias, pleural effusion, wound infections, or other cardiovascular complications were observed. Postoperative recovery was uneventful. The mean LIMA harvesting time was 111 ± 11.1 minutes, and the total operation duration was 282 ± 7 minutes. The average blood loss was 167 ± 76 mL. Patients remained in the intensive care unit (ICU) for 1 day, with a total hospital stay averaging 8 days.

Conclusion. This intervention is an intermediate step in performing a full robotic bypass, but further studies are needed to analyze the promise and necessity of this technique.

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