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      The role of robotics in cardiac surgery: a systematic review.

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          Abstract

          The application of robotic technologies in cardiac surgery has provided the possibility for minimally invasive access inside the thorax and avoidance of a median sternotomy. Given that current evidence seems promising, we sought to systematically review the existing literature regarding the efficacy, feasibility and mortality rate associated with robotic cardiac surgery. The PubMed and Cochrane bibliographical databases were thoroughly searched for the following MeSH terms: "robotic", "cardiac surgery" and "heart surgery". Original studies on robotic cardiac surgery in more than ten cases and reporting on the associated peri- or post-operative mortality were deemed eligible. Twenty-eight studies were included and provided data for 5993 patients with a mean age of 59.8 years. Approximately, one out of two patients (49.2%) underwent robotic CABG, while the other half (49.9%) underwent robotic MVR. Robotic atrial septal defect repair and atrial tumor resection were performed in a small proportion (0.9%) of the patients. Mean 30-day mortality was 0.7% ranging from 0 to 0.8% among the different types of surgery, while late mortality was 0.8% ranging from 0 to 1% with a mean follow-up period of 40.1 months. Our findings demonstrate that the application of robotics in cardiac surgery has provided a safe and efficacious alternative to the traditional techniques. However, more trials are necessary to elucidate all of its aspects.

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          Author and article information

          Journal
          J Robot Surg
          Journal of robotic surgery
          Springer Science and Business Media LLC
          1863-2491
          1863-2483
          Feb 2019
          : 13
          : 1
          Affiliations
          [1 ] Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Athens Medical School, National and Kapodistrian University of Athens, Agiou Thoma Str, 11b, Goudi, 11527, Athens, Greece. doulamis.i@gmail.com.
          [2 ] Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece. doulamis.i@gmail.com.
          [3 ] Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Athens Medical School, National and Kapodistrian University of Athens, Agiou Thoma Str, 11b, Goudi, 11527, Athens, Greece.
          [4 ] Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece.
          [5 ] 3rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
          [6 ] 1st Department of Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
          [7 ] Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
          [8 ] Department of Surgery, Duke University Medical Center, Durham, NC, USA.
          [9 ] 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
          Article
          10.1007/s11701-018-0875-5
          10.1007/s11701-018-0875-5
          30255360
          ab6e669a-a8c9-4c00-bebc-8f7968c946ea
          History

          Endoscopic,Robotic cardiac surgery,Robotically assisted

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