Hybrid Coronary Revascularization Using The Davinci Robot - First Experience In Poland
Radoslaw Smoczynski1, Tomasz Pawlowski2, Dominik Drobinski1, Jakub Staromlynski1, Mariusz Kowalewski1, Robert Gil2, Piotr Suwalski1.
1Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland, 2Department of Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland.
BACKGROUND: The surgical treatment of coronary artery disease is still associated with major trauma and longpostoperative rehabilitation. The development in minimally invasive techniques has changed theperception and offers comparable quality of anastomosis. The pilot study presents early robotic totally endoscopic coronary artery bypass (TECAB) experience and patient’s rapid recovery after surgery measured in EQ-5D-5L questionnaire in 6-months follow-up. METHODS: The prospective study collects data of elective patients qualified for robotic hybrid coronaryrevascularization (HCR) by local Heart Team. The surgical stage was performed with the Intuitiveda Vinci Xi Surgical System. Pre-, postoperative, and 6-months follow-up data were analyzed withemphasis on, length of stay (LOS), pain scale and EQ-5D-5L questionnaire for quality of live(QoL). RESULTS: Between September 2020 and October 2021 procedure with the da Vinci Xi System was performed on 40 patients. Mean age of patients was 65.7+/-6.7 and Euroscore II was 0.8+/-0.4. Robotic cardiac surgery operation was performed as single step or hybrid approach (34 patients) with stent implantation. Postoperative intubation time was 2,4+/-1,4 and intensive care observation time was 21,4+/-7,3h. The most patients were discharge on 2nd postoperative day. Comparison of the EQ-5D-5L questionnaire showed reduction in collected points (9,2+/-2 vs. 7,6+/-2,2 vs. 5,5+/-0,7).
CONCLUSIONS:The hybrid robotic TECAB is safe and feasible minimally invasive technique of coronary artery revascularization. It shows excellent early results with low pain expression, short LOS and high QoL surgery perception in 6-moths follow-up.
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