Skip to main content
SpringerLink
Log in

Applications of Surgical Robotics in Cardiac Surgery

  • Chapter
  • First Online:
Surgical Robotics

Abstract

Minimally invasive surgery has revolutionized many fields of surgery over the last two decades. Robotic assisted surgery is the latest iteration towards less invasive techniques. Cardiac surgeons have slowly adapted minimally invasive and robotic techniques into their armamentarium. In particular, minimally invasive mitral valve surgery has evolved over the last decade and become the preferred method of mitral valve repair and replacement at certain specialized centers worldwide because of excellent results. We have developed a robotic mitral valve surgery program which utilizes the da Vinci® telemanipulation system allowing the surgeon to perform complex mitral valve repairs through 5 mm port sites rather than a traditional median sternotomy. In this rapidly evolving field, we review the evolution and clinical results of robotically-assisted mitral valve surgery and review other cardiac surgical procedures for which da Vinci® is currently being used.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Cohn, L.H., Adams, D.H., Couper, G.S., Bichell, D.P.: Minimally invasive aortic valve replacement. Semin. Thorac. Cardiovasc. Surg. 9, 331-336 (1997)

    Google Scholar 

  2. Cosgrove, D.M., III, Sabik, J.F.: Minimally invasive approach for aortic valve operations. Ann. Thorac. Surg. 62, 596-597 (1996)

    Article  Google Scholar 

  3. Cosgrove, D.M., III, Sabik, J.F., Navia, J.L.: Minimally invasive valve operations. Ann. Thorac. Surg. 65, 1535-1538 (1998)

    Article  Google Scholar 

  4. Pompili, M.F., Stevens, J.H., Burdon, T.A., Siegel, L.C., Peters, W.S., Ribakove, G.H., Reitz, B.A.: Port-access mitral valve replacement in dogs. J. Thorac. Cardiovasc. Surg. 112, 1268-1274 (1996)

    Article  Google Scholar 

  5. Falk, V., Walther, T., Diegeler, A., Wendler, R., Autschbach, R., van Son, J.A., Siegel, L.C., Pompilli, M.F., Mohr, F.W.: Echocardiographic monitoring of minimally invasive mitral valve surgery using an endoaortic clamp. J. Heart Valve Dis. 5, 630-637 (1996)

    Google Scholar 

  6. Arom, K.V., Emery, R.W.: Minimally invasive mitral operations. Ann. Thorac. Surg. 63, 1219-1220 (1997)

    Article  Google Scholar 

  7. Arom, K.V., Emery, R.W., Kshettry, V.R., Janey, P.A.: Comparison between port-access and less invasive valve surgery. Ann. Thorac. Surg. 68, 1525-1528 (1999)

    Article  Google Scholar 

  8. Cohn, L.H., Adams, D.H., Couper, G.S., Bichell, D.P., Rosborough, D.M., Sears, S.P., Aranki, S.F.: Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann. Surg. 226, 421-426 (1997)

    Article  Google Scholar 

  9. Fann, J.I., Pompili, M.F., Burdon, T.A., Stevens, J.H., St Goar, F.G., Reitz, B.A.: Minimally invasive mitral valve surgery. Semin. Thorac. Cardiovasc. Surg. 9, 320-330 (1997)

    Google Scholar 

  10. Fann, J.I., Pompili, M.F., Stevens, J.H., Siegel, L.C., St Goar, F.G., Burdon, T.A., Reitz, B.A.: Port-access cardiac operations with cardioplegic arrest. Ann. Thorac. Surg. 63, S35-S39 (1997)

    Article  Google Scholar 

  11. Gundry, S.R., Shattuck, O.H., Razzouk, A.J., del Rio, M.J., Sardari, F.F., Bailey, L.L.: Facile minimally invasive cardiac surgery via ministernotomy. Ann. Thorac. Surg. 65, 1100-1104 (1998)

    Article  Google Scholar 

  12. Konertz, W., Waldenberger, F., Schmutzler, M., Ritter, J., Liu, J.: Minimal access valve surgery through superior partial sternotomy: a preliminary study. J. Heart Valve Dis. 5, 638-640 (1996)

    Google Scholar 

  13. Mohr, F.W., Falk, V., Diegeler, A., Walther, T., van Son, J.A., Autschbach, R.: Minimally invasive port-access mitral valve surgery. J. Thorac. Cardiovasc. Surg. 115, 567-574 (1998)

    Article  Google Scholar 

  14. Navia, J.L., Cosgrove, D.M., III.: Minimally invasive mitral valve operations. Ann. Thorac. Surg. 62, 1542-1544 (1996)

    Article  Google Scholar 

  15. Spencer, F.C., Galloway, A.C., Grossi, E.A., Ribakove, G.H., Delianides, J., Baumann, F.G., Colvin, S.B.: Recent developments and evolving techniques of mitral valve reconstruction. Ann. Thorac. Surg. 65, 307-313 (1998)

    Article  Google Scholar 

  16. Carpentier, A., Loulmet, D., Carpentier, A., Le Bret, E., Haugades, B., Dassier, P., Guibourt, P.: Open heart operation under videosurgery and minithoracotomy. First case (mitral valvuloplasty) operated with success. C. R. Acad. Sci. III 319, 219-223 (1996)

    Google Scholar 

  17. Chitwood, W.R., Jr., Elbeery, J.R., Chapman, W.H., Moran, J.M., Lust, R.L., Wooden, W.A.,Deaton, D.H.: Video-assisted minimally invasive mitral valve surgery: the “micro-mitral” operation. J. Thorac. Cardiovasc. Surg. 113, 413-414 (1997)

    Article  Google Scholar 

  18. Chitwood, W.R., Jr., Elbeery, J.R., Moran, J.F.: Minimally invasive mitral valve repair using transthoracic aortic occlusion. Ann. Thorac. Surg. 63, 1477-1479 (1997)

    Article  Google Scholar 

  19. Chitwood, W.R., Jr., Wixon, C.L., Elbeery, J.R., Moran, J.F., Chapman, W.H., Lust, R.M.: Video-assisted minimally invasive mitral valve surgery. J. Thorac. Cardiovasc. Surg. 114, 773-780 (1997)

    Article  Google Scholar 

  20. Falk, V., Walther, T., Autschbach, R., Diegeler, A., Battellini, R., Mohr, F.W.: Robot-assisted minimally invasive solo mitral valve operation. J. Thorac. Cardiovasc. Surg. 115, 470-471 (1998)

    Article  Google Scholar 

  21. Felger, J.E., Nifong, L.W., Chitwood, W.R., Jr. The evolution of and early experience with robot-assisted mitral valve surgery. Surg. Laparosc. Endosc. Percutan. Tech. 12, 58-63 (2002)

    Article  Google Scholar 

  22. Loulmet, D.F., Carpentier, A., Cho, P.W., Berrebi, A., d’Attellis, N., Austin, C.B., Couetil, J.P., Lajos, P.: Less invasive techniques for mitral valve surgery. J. Thorac. Cardiovasc. Surg. 115, 772-779 (1998)

    Article  Google Scholar 

  23. Mohr, F.W., Falk, V., Diegeler, A., Autschback, R.: Computer-enhanced coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg. 117, 1212-1214 (1999)

    Article  Google Scholar 

  24. Chitwood, W.R. Jr., Nifong, L.W., Elbeery, J.E., Chapman, W.H., Albrecht, R., Kim, V., Young, J.A.: Robotic mitral valve repair: trapezoidal resection and prosthetic annuloplasty with the da vinci surgical system. J. Thorac. Cardiovasc. Surg. 120, 1171-1172 (2000)

    Article  Google Scholar 

  25. Mehmanesh, H., Henze, R., Lange, R.: Totally endoscopic mitral valve repair. J. Thorac. Cardiovasc. Surg. 123, 96-97 (2002)

    Article  Google Scholar 

  26. Nifong, L.W., Chu, V.F., Bailey, B.M., Maziarz, D.M., Sorrell, V.L., Holbert, D., Chitwood, W.R., Jr. Rsobotic mitral valve repair: experience with the da Vinci system. Ann. Thorac. Surg. 75, 438-442 (2003)

    Article  Google Scholar 

  27. Nifong, L.W., Chitwood, W.R., Pappas, P.S., Smith, C.R., Argenziano, M., Starnes, V.A., Shah, P.M.: Robotic mitral valve surgery: a United States multicenter trial. J. Thorac. Cardiovasc. Surg. 129, 1395-1404 (2005)

    Article  Google Scholar 

  28. Nifong, L.W., Chitwood, W.R., Jr. Challenges for the anesthesiologist: robotics? Anesth. Analg. 96, 1-2 (2003)

    Article  Google Scholar 

  29. Reichenspurner, H., Detter, C., Deuse, T., Boehm, D.H., Treede, H., Reichart, B.: Video and robotic-assisted minimally invasive mitral valve surgery: a comparison of the Port-Access and transthoracic clamp techniques. Ann. Thorac. Surg. 79, 485-490 (2005)

    Article  Google Scholar 

  30. Casselman, F.P., Van Slycke, S., Wellens, F., De Geest, R., Degrieck, I., Van Praet, F., Vermeulen, Y., Vanermen, H.: Mitral valve surgery can now routinely be performed endoscopically. Circulation 108(Suppl 1), II48-II54 (2003)

    Google Scholar 

  31. Greelish, J.P., Cohn, L.H., Leacche, M., Mitchell, M., Karavas, A., Fox, J., Byrne, J.G., Aranki, S.F., Couper, G.S.: Minimally invasive mitral valve repair suggests earlier operations for mitral valve disease. J. Thorac. Cardiovasc. Surg. 126, 365-371 (2003)

    Article  Google Scholar 

  32. Muhs, B.E., Galloway, A.C., Lombino, M., Silberstein, M., Grossi, E.A., Colvin, S.B., Lamparello, P., Jacobowitz, G., Adelman, M.A., Rockman, C., Gagne, P.J.: Arterial injuries from femoral artery cannulation with port access cardiac surgery. Vasc. Endovasc. Surg. 39, 153-158 (2005).

    Article  Google Scholar 

  33. Rodriguez, E., Cook, R.C., Chu, M.W., Chitwood, W.R.: Minimally invasive bi-atrial cryomaze operation for atrial fibrillation. Optechstcvs. 14, 208-223 (2010)

    Google Scholar 

  34. Tatooles, A.J., Pappas, P.S., Gordon, P.J., Slaughter, M.S.: Minimally invasive mitral valve repair using the da Vinci robotic system. Ann. Thorac. Surg. 77, 1978-1982 (2004)

    Article  Google Scholar 

  35. Bonatti, J., Schachner, T., Bonaros, N., Ohlinger, A., Danzmayr, M., Jonetzko, P., Friedrich, G., Kolbitsch, C., Mair, P., Laufer, G.: Technical challenges in totally endoscopic robotic coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 131, 146-153 (2006)

    Article  Google Scholar 

  36. Chitwood, W.R., Jr., Rodriguez, E., Chu, M.W., Hassan, A., Ferguson, T.B., Vos, P.W., Nifong, L.W.: Robotic mitral valve repairs in 300 patients: a single-center experience. J. Thorac. Cardiovasc. Surg. 136, 436-441 (2008)

    Article  Google Scholar 

  37. Jones, B.A., Krueger, S., Howell, D., Meinecke, B., Dunn, S.: Robotic mitral valve repair: a community hospital experience. Tex. Heart Inst. J. 32, 143-146 (2005)

    Google Scholar 

  38. Woo, Y.J., Nacke, E.A.: Robotic minimally invasive mitral valve reconstruction yields less blood product transfusion and shorter length of stay. Surgery 140, 263-267 (2006)

    Article  Google Scholar 

  39. Folliguet, T., Vanhuyse, F., Constantino, X., Realli, M., Laborde, F.: Mitral valve repair robotic versus sternotomy. Eur. J. Cardiothorac. Surg. 29, 362-366 (2006)

    Article  Google Scholar 

  40. Murphy, D.A., Miller, J.S., Langford, D.A., Snyder, A.B.: Endoscopic robotic mitral valve surgery. J. Thorac. Cardiovasc. Surg. 132, 776-781 (2006)

    Article  Google Scholar 

  41. Chu, M.W., Gersch, K.A., Rodriguez, E., Nifong, L.W., Chitwood, W.R., Jr. Robotic “haircut” mitral valve repair: posterior leaflet-plasty. Ann. Thorac. Surg. 85, 1460-1462 (2008)

    Article  Google Scholar 

  42. Lawrie, G.M.: Mitral valve: toward complete repairability. Surg. Technol. Int. 15, 189-197 (2006)

    Google Scholar 

  43. Bolotin, G., Kypson, A.P., Nifong, L.W., Chitwood, W.R., Jr.: Robotically-assisted left atrial fibrillation ablation and mitral valve repair through a right mini-thoracotomy. Ann. Thorac. Surg. 78, e63-e64 (2004)

    Article  Google Scholar 

  44. Loulmet, D.F., Patel, N.C., Patel, N.U., Frumkin, W.I., Santoni-Rugiu, F., Langan, M.N., Subramanian, V.A.: First robotic endoscopic epicardial isolation of the pulmonary veins with microwave energy in a patient in chronic atrial fibrillation. Ann. Thorac. Surg. 78, e24-e25 (2004)

    Article  Google Scholar 

  45. Akpinar, B., Guden, M., Sagbas, E., Sanisoglu, I., Caynak, B., Bayramoglu, Z.: Robotic-enhanced totally endoscopic mitral valve repair and ablative therapy. Ann. Thorac. Surg. 81, 1095-1098 (2006)

    Article  Google Scholar 

  46. Pruitt, J.C., Lazzara, R.R., Dworkin, G.H., Badhwar, V., Kuma, C., Ebra, G.: Totally endoscopic ablation of lone atrial fibrillation: initial clinical experience. Ann. Thorac. Surg. 81, 1325-1330 (2006)

    Article  Google Scholar 

  47. Reade, C.C., Johnson, J.O., Bolotin, G., Freund, W.L., Jr., Jenkins, N.L., Bower, C.E., Masroor, S., Kypson, A.P., Nifong, L.W., Chitwood, W.R., Jr.: Combining robotic mitral valve repair and microwave atrial fibrillation ablation: techniques and initial results. Ann. Thorac. Surg. 79, 480-484 (2005)

    Article  Google Scholar 

  48. Katz, M.R., Van Praet, F., de Canniere, D., Murphy, D., Siwek, L., Seshadri-Kreaden, U., Friedrich, G., Bonatti, J.: Integrated coronary revascularization: percutaneous coronary intervention plus robotic totally endoscopic coronary artery bypass. Circulation 114, I473-I476 (2006)

    Article  Google Scholar 

  49. Falk, V., Jacobs, S., Gummert, J., Walther, T.: Robotic coronary artery bypass grafting (CABG)–the Leipzig experience. Surg. Clin. North Am. 83, 1381-1386, ix (2003)

    Article  Google Scholar 

  50. Vassiliades, T.A., Jr.: Technical aids to performing thoracoscopic robotically-assisted internal mammary artery harvesting. Heart Surg. Forum 5, 119-124 (2002)

    Google Scholar 

  51. Kappert, U., Cichon, R., Gulielmos, V., Schneider, J., Schramm, I., Nicolai, J., Tugtekin, S.M., Schueler, S.: Robotic-enhanced Dresden technique for minimally invasive bilateral internal mammary artery grafting. Heart Surg. Forum 3, 319-321 (2000)

    Google Scholar 

  52. Loulmet, D., Carpentier, A., d’Attellis, N., Berrebi, A., Cardon, C., Ponzio, O., Aupecle, B., Relland, J.Y.: Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J. Thorac. Cardiovasc. Surg. 118, 4-10 (1999)

    Article  Google Scholar 

  53. Falk, V., Diegeler, A., Walther, T., Banusch, J., Brucerius, J., Raumans, J., Autschbach, R., Mohr, F.W.: Total endoscopic computer enhanced coronary artery bypass grafting. Eur. J. Cardiothorac. Surg. 17, 38-45 (2000)

    Article  Google Scholar 

  54. Falk, V., Diegeler, A., Walther, T., Jacobs, S., Raumans, J., Mohr, F.W.: Total endoscopic off-pump coronary artery bypass grafting. Heart Surg. Forum 3, 29-31 (2000)

    Google Scholar 

  55. Dogan, S., Aybek, T., Andressen, E., Byhahn, C., Mierdl, S., Westphal, K., Matheis, G., Moritz, A., Wimmer-Greinecker, G.: Totally endoscopic coronary artery bypass grafting on cardiopulmonary bypass with robotically enhanced telemanipulation: report of forty-five cases. J. Thorac. Cardiovasc. Surg. 123, 1125-1131 (2002)

    Article  Google Scholar 

  56. Subramanian, V.A., Patel, N.U., Patel, N.C., Loulmet, D.F.: Robotic assisted multivessel minimally invasive direct coronary artery bypass with port-access stabilization and cardiac positioning: paving the way for outpatient coronary surgery? Ann. Thorac. Surg. 79, 1590-1596 (2005).

    Article  Google Scholar 

  57. Srivastava, S., Gadasalli, S., Agusala, M., Kolluru, R., Naidu, J., Shroff, M., Barrera, R., Quismundo, S., Srivastava, V.: Use of bilateral internal thoracic arteries in CABG through lateral thoracotomy with robotic assistance in 150 patients. Ann. Thorac. Surg. 81, 800-806 (2006)

    Article  Google Scholar 

  58. Argenziano, M., Katz, M., Bonatti, J., Srivastava, S., Murphy, D., Poirier, R., Loulmet, D., Siwek, L., Kreaden, U., Ligon, D.: Results of the prospective multicenter trial of robotically assisted totally endoscopic coronary artery bypass grafting. Ann. Thorac. Surg. 81, 1666-1674 (2006)

    Article  Google Scholar 

  59. Anderson, C.A., Rodriguez, E., Chitwood, W.R., Jr.: Robotically assisted coronary surgery: what is the future? Curr. Opin. Cardiol. 22, 541-544 (2007)

    Article  Google Scholar 

  60. Gao, C., Yang, M., Wu, Y., Wang, G., Xiao, C., Liu, H., Lu, C.: Hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on beating heart and stent placement. Ann. Thorac. Surg. 87, 737-741 (2009)

    Article  Google Scholar 

  61. McAlister, F.A., Ezekowitz, J., Hooton, N., Vandermeer, B., Spooner, C., Dryden, D.M., Page, R.L., Hlatky, M.A., Rowe, B.H.: Cardiac resynchronization therapy for patients with left ventricular systolic dysfunction: a systematic review. JAMA. 297, 2502-2514 (2007)

    Article  Google Scholar 

  62. Alonso, C., Leclercq, C., d’Allonnes, F.R., Pavin, D., Victor, F., Mabo, P., Daubert, J.C.: Six year experience of transvenous left ventricular lead implantation for permanent biventricular pacing in patients with advanced heart failure: technical aspects. Heart 86, 405-410 (2001)

    Article  Google Scholar 

  63. Derose, J.J., Jr., Belsley, S., Swistel, D.G., Shaw, R., Ashton, R.C., Jr.: Robotically assisted left ventricular epicardial lead implantation for biventricular pacing: the posterior approach. Ann. Thorac. Surg. 77, 1472-1474 (2004)

    Article  Google Scholar 

  64. Navia, J.L., Atik, F.A., Grimm, R.A., Garcia, M., Vega, P.R., Myhre, U., Starling, R.C.,Wilkoff, B.L., Martin, D., Houghtaling, P.L., Blackstone, E.H., Cosgrove, D.M.: Minimally invasive left ventricular epicardial lead placement: surgical techniques for heart failure resynchronization therapy. Ann. Thorac. Surg. 79, 1536-1544 (2005)

    Article  Google Scholar 

  65. Murphy, D.A., Miller, J.S., Langford, D.A.: Robot-assisted endoscopic excision of left atrial myxomas. J. Thorac. Cardiovasc. Surg. 130, 596-597 (2005)

    Article  Google Scholar 

  66. Woo, Y.J., Grand, T.J., Weiss, S.J.: Robotic resection of an aortic valve papillary fibroelastoma. Ann. Thorac. Surg. 80, 1100-1102 (2005)

    Article  Google Scholar 

  67. Suematsu, Y., Mora, B.N., Mihaljevic, T., del Nido, P.J.: Totally endoscopic robotic-assisted repair of patent ductus arteriosus and vascular ring in children. Ann. Thorac. Surg. 80, 2309-2313 (2005)

    Article  Google Scholar 

  68. Bonaros, N., Schachner, T., Oehlinger, A., Ruetzler, E., Kolbitsch, C., Dichtl, W., Mueller, S., Laufer, G., Bonatti, J.: Robotically assisted totally endoscopic atrial septal defect repair: insights from operative times, learning curves, and clinical outcome. Ann. Thorac. Surg. 82, 687-693 (2006)

    Article  Google Scholar 

  69. Argenziano, M., Oz, M.C., Kohmoto, T., Morgan, J., Dimitui, J., Mongero, L., Beck, J., Smith, C.R.: Totally endoscopic atrial septal defect repair with robotic assistance. Circulation 108(Suppl 1), II191-II194 (2003)

    Google Scholar 

  70. Morgan, J.A., Peacock, J.C., Kohmoto, T., Garrido, M.J., Schanzer, B.M., Kherani, A.R., Vigilance, D.W., Cheema, F.H., Kaplan, S., Smith, C.R., Oz, M.C., Argenziano, M.: Robotic techniques improve quality of life in patients undergoing atrial septal defect repair. Ann. Thorac. Surg. 77, 1328-1333 (2004)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, 27834, USA

    W. Rodolph Chitwood

Authors
  1. E. J. Lehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Rodolph Chitwood
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Rodolph Chitwood .

Editor information

Editors and Affiliations

  1. Baskin School of Engineering SOE-3, Department of Computer Engineering, University of California Santa Cruz, 1156 High Street, Santa Cruz, 95064, California, USA

    Jacob Rosen

  2. , Department of Electrical Engineering, University of Washington, Box 325500, Seattle, 98195-2500, Washington, USA

    Blake Hannaford

  3. Medical Center, Dept. Surgery, University of Washington, Seattle, 98195, Washington, USA

    Richard M. Satava

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Lehr, E.J., Rodriguez, E., Chitwood, W.R. (2011). Applications of Surgical Robotics in Cardiac Surgery. In: Rosen, J., Hannaford, B., Satava, R. (eds) Surgical Robotics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1126-1_29

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1126-1_29

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-1125-4

  • Online ISBN: 978-1-4419-1126-1

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics

Search

Navigation