Robotic Cardiac Surgery: The Future Gold Standard or An Unnecessary Extravagance?

Abstract

The shift towards minimally invasive surgery has paved the way for robotic technologies being used to perform operations. Robots have frequently been used for prostatectomy and hysterectomy, whereas their application in cardiac surgery is confined to specialized, high-volume centres[1]. Robotic cardiac surgery utilizes small port incisions avoiding the need for a full sternotomy. This provides benefits in terms of less pain, less bleeding, earlier discharge, quicker recovery, and improved cosmesis. Traditional, video-assisted, or laparoscopic surgeries have many of these advantages, but they have technical limitations due to the use of long-shafted instruments and the fulcrum effect. Robotic surgery has technical advantages as it improves dexterity by allowing the instruments to move with six degrees of freedom. Other advantages include avoidance of tremor and ambidexterity. Additionally, the three-dimensional (3-D) highdefinition imaging greatly improves visualization. The enhanced visual feedback, through observation of tissue displacement and deformation, substitutes for the lack of tactile feedback[2]. In cardiac surgery, robotic technology has most commonly been used to perform mitral valve surgery and coronary artery bypass surgery[3].