Ahmet Ümit Güllü1, Şahin Şenay1, Egemen Ersin2, Önder Demirhisar2, Muharrem Kocyigit3, Cem Alhan1. 1. Department of Cardiovascular Surgery, Acıbadem Mehmet ali Aydinlar University School of Medicine, Istanbul, Turkey. 2. Programme of Perfusion, Acıbadem Mehmet ali Aydinlar University School of Medicine, Istanbul, Turkey. 3. Department of Anesthesiology, Acıbadem Mehmet ali Aydinlar University School of Medicine, Istanbul, Turkey.
Abstract
BACKGROUND: The feasibility, safety and advantages of minimally invasive or robotic repair of atrial septal defect (ASD) in adults were reported previously. However, there is limited data for the application of these systems in paediatric patients. Although current robotic systems still have large instruments for surgical repair in children, some appropriate patients may benefit from this technology. METHOD: A 6-year-old child with ASD underwent robotic assistant repair via Da-Vinci Robotic Systems. Venous cannulation was achieved by internal jugular and femoral veins (10F-14F) and arterial cannulation was performed via femoral artery under transesophageal echocardiography (TEE) guidance (10F). A 3 cm incision was made in the right fourth intercostal space, used for working and the camera port in the same time. The ports were placed considering not to damage the potential developing breast tissue. After the port implantation (8F) and cardiac arrest, the ASD repair was completed with primary closure technique. RESULT: The perioperative period was uneventful and the patient was discharged from hospital 5 days after surgery. CONCLUSION: ASD closure with robotic assistant was achieved in a large enough sized paediatric patient. With the development of thinner and shorter robotic arms, it will be possible to use robotic assistance more common during the repair of congenital heart diseases.
BACKGROUND: The feasibility, safety and advantages of minimally invasive or robotic repair of atrial septal defect (ASD) in adults were reported previously. However, there is limited data for the application of these systems in paediatric patients. Although current robotic systems still have large instruments for surgical repair in children, some appropriate patients may benefit from this technology. METHOD: A 6-year-old child with ASD underwent robotic assistant repair via Da-Vinci Robotic Systems. Venous cannulation was achieved by internal jugular and femoral veins (10F-14F) and arterial cannulation was performed via femoral artery under transesophageal echocardiography (TEE) guidance (10F). A 3 cm incision was made in the right fourth intercostal space, used for working and the camera port in the same time. The ports were placed considering not to damage the potential developing breast tissue. After the port implantation (8F) and cardiac arrest, the ASD repair was completed with primary closure technique. RESULT: The perioperative period was uneventful and the patient was discharged from hospital 5 days after surgery. CONCLUSION: ASD closure with robotic assistant was achieved in a large enough sized paediatric patient. With the development of thinner and shorter robotic arms, it will be possible to use robotic assistance more common during the repair of congenital heart diseases.
Authors: Christopher D Roche; Gautam R Iyer; Minh H Nguyen; Sohaima Mabroora; Anthony Dome; Kareem Sakr; Rohan Pawar; Vincent Lee; Christopher C Wilson; Carmine Gentile Journal: Front Robot AI Date: 2022-01-18