Robotic coronary revascularization in Europe, state of art and future of EACTS-endorsed Robotic Cardiothoracic Surgery Taskforce
Abstract
It has been >20 years ago that robotic-assisted coronary artery bypass grafting (RA-CABG) has been introduced, but the adoption of this technique is still rather limited worldwide, although recently a slight increase in numbers has been documented in Europe [1, 2]. Like many novelties, after the introduction, it has been picked up by only a few dedicated surgeons in highly specialized centres.
Due to limited series, based mostly on single-centre experiences, extensive clinical outcome data and results on long-term benefits are lacking as well as the acknowledgement in international cardiosurgical society and anchorage in EACTS-supported guidelines. The limited number of robotic platforms and high procedural costs combined with the absence of dedicated training programs are considered to be responsible for reduced adoption.
The safety of robotic techniques, the benefit of the left internal mammary artery (LIMA) to left anterior descending (LAD) over percutaneous coronary interventions (PCI) and hybrid procedures have also been questioned. Nonetheless, after 20 years, the robotic surgical technique has evolved.
Consequentially, the number of off-pump robot-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) has rapidly grown lately [1, 2]. It seems that the robotic approach to ischaemic heart disease has earned its place in our surgical armamentarium.
This editorial will address the current standards of care and future perspectives of robotics in coronary revascularization.