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Published in: General Thoracic and Cardiovascular Surgery 1/2020

01-01-2020 | Heart Surgery | Original Article

Robotic cardiac surgery impact of a new patient-side assistant on outcomes

Authors: Mackenzie McCrorey, Hiroto Kitahara, Dorothy Krienbring, Brooke Patel, Sarah Nisivaco, Husam H. Balkhy

Published in: General Thoracic and Cardiovascular Surgery | Issue 1/2020

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Abstract

Objective

Very few studies have focused on the experience of the patient-side assistant in robotic cardiac surgery. We investigated whether the retirement of a highly experienced robotic patient-side assistant and replacement with a new assistant had an effect on surgical outcomes.

Methods

In 4/2016, the established patient-side assistant retired after spending 8 months training a new patient-side assistant. A retrospective analysis of 216 patients was performed; 108 patients over a 9 month period just prior to arrival of the new patient-side assistant (Group 1), and 108 patients over 8 months just subsequent to departure of the established assistant (Group 2). Case distribution, pre-operative characteristics, and surgical outcomes were collected and compared.

Results

Case volume increased in Group 2 with the new assistant. The mean age and rate of pre-op CVA for Group 1 was lower, but, otherwise, patient demographics were not significantly different. Group 1 had more intracardiac cases and group 2 had more triple-vessel TECABs. Overall operative time was not different between the two groups. Perioperative outcomes including hospital length of stay major adverse cardiovascular events and mortality were similar between the two groups.

Conclusions

We conclude that the transition to a new robotic cardiac surgical patient-side assistant does not have to affect the progress of a busy robotic program. If adequate time for training and gradual assumption of responsibility is ensured, it is feasible to make this transition without loss of volume or compromise in patient outcomes.
Literature
1.
go back to reference Mihaljevic T, et al. Robotic repair of posterior mitral valve prolapse versus conventional approaches: potential realized. J Thorac Cardiovasc Surg. 2011;141:72–80.CrossRef Mihaljevic T, et al. Robotic repair of posterior mitral valve prolapse versus conventional approaches: potential realized. J Thorac Cardiovasc Surg. 2011;141:72–80.CrossRef
2.
go back to reference Suri R, et al. Robotic mitral valve repair for all categories of leaflet prolapse: improving patient appeal and advancing standard of Care. Mayo Clin Proc. 2011;86(9):838–44.CrossRef Suri R, et al. Robotic mitral valve repair for all categories of leaflet prolapse: improving patient appeal and advancing standard of Care. Mayo Clin Proc. 2011;86(9):838–44.CrossRef
3.
go back to reference Wang S. Traditional coronary artery bypass graft versus totally endoscopic coronary artery bypass graft or robot-assisted coronary artery bypass graft—meta-analysis of 16 studies. Eur Rev Med Pharmacol Sci. 2014;18(6):790–7.PubMed Wang S. Traditional coronary artery bypass graft versus totally endoscopic coronary artery bypass graft or robot-assisted coronary artery bypass graft—meta-analysis of 16 studies. Eur Rev Med Pharmacol Sci. 2014;18(6):790–7.PubMed
4.
go back to reference Balkhy H, et al. Right internal mammary artery use in 140 robotic totally endoscopic bypass cases: toward multiarterial grafting. Innovations. 2017;12(1):9–14.CrossRef Balkhy H, et al. Right internal mammary artery use in 140 robotic totally endoscopic bypass cases: toward multiarterial grafting. Innovations. 2017;12(1):9–14.CrossRef
5.
go back to reference Whellan DJ, et al. Trends in robotic-assisted coronary artery bypass grafts: a study of the society of thoracic surgeons adult cardiac surgery database, 2006 to 2012. Ann Thorac Surg. 2016;102(1):140–6.CrossRef Whellan DJ, et al. Trends in robotic-assisted coronary artery bypass grafts: a study of the society of thoracic surgeons adult cardiac surgery database, 2006 to 2012. Ann Thorac Surg. 2016;102(1):140–6.CrossRef
6.
go back to reference Valdis M, et al. Evaluation of robotic cardiac surgery simulation training: a randomized controlled trial. J Thorac Cardiovasc Surg. 2016;151:1498–505.CrossRef Valdis M, et al. Evaluation of robotic cardiac surgery simulation training: a randomized controlled trial. J Thorac Cardiovasc Surg. 2016;151:1498–505.CrossRef
7.
go back to reference Gillinov M, et al. Watch one, do one, teach one. J Thorac Cardiovasc Surg. 2016;151:1506–7.CrossRef Gillinov M, et al. Watch one, do one, teach one. J Thorac Cardiovasc Surg. 2016;151:1506–7.CrossRef
8.
go back to reference Coste-Maniere E, et al. Planning, simulation, and augmented reality for robotic cardiac procedures: the STARS system of the ChIR team. Semin Thorac Cardiovasc Surg. 2003;15:141–56.CrossRef Coste-Maniere E, et al. Planning, simulation, and augmented reality for robotic cardiac procedures: the STARS system of the ChIR team. Semin Thorac Cardiovasc Surg. 2003;15:141–56.CrossRef
9.
go back to reference Potretzke AM, et al. The role of the assistant during robot-assisted partial nephrectomy: does experience matter? J Robot Surg. 2016;10:129–34.CrossRef Potretzke AM, et al. The role of the assistant during robot-assisted partial nephrectomy: does experience matter? J Robot Surg. 2016;10:129–34.CrossRef
10.
go back to reference Sgarbura O, et al. The decisive role of the patient-side surgeon in robotic surgery. Surg Endosc. 2010;24:3149–55.CrossRef Sgarbura O, et al. The decisive role of the patient-side surgeon in robotic surgery. Surg Endosc. 2010;24:3149–55.CrossRef
11.
go back to reference Nayyar R, et al. Impact of assistant surgeon on outcomes in robotic surgery. Indian J Urol. 2016;32:204–9.CrossRef Nayyar R, et al. Impact of assistant surgeon on outcomes in robotic surgery. Indian J Urol. 2016;32:204–9.CrossRef
12.
go back to reference Carter-Brooks CM, Du AL, Bonidie MJ, Shepherd JP. The impact of a dedicated robotic team on robotic-assisted sacrocolpopexy outcomes. Female Pelvic Med Reconstr Surg. 2018;24(1):13–6.CrossRef Carter-Brooks CM, Du AL, Bonidie MJ, Shepherd JP. The impact of a dedicated robotic team on robotic-assisted sacrocolpopexy outcomes. Female Pelvic Med Reconstr Surg. 2018;24(1):13–6.CrossRef
13.
go back to reference Kim ER, Lim C, Kim DJ, Kim JS, Park KH. Robot-assisted cardiac surgery using the Da Vinci surgical system: a single center experience. Korean J Thorac Cardiovasc Surg. 2015;48(2):99–104.CrossRef Kim ER, Lim C, Kim DJ, Kim JS, Park KH. Robot-assisted cardiac surgery using the Da Vinci surgical system: a single center experience. Korean J Thorac Cardiovasc Surg. 2015;48(2):99–104.CrossRef
14.
go back to reference Rodriguez E, Nifong WL, Bonatti J, Casula R, Falk V, Folliguet TA, Kiaii BB, Mack MJ, Mihaljevic T, Smith JM, Suri RM, Bavaria JE, MacGillivray TE, Chitwood WR Jr. Pathway for surgeons and programs to establish and maintain a successful robot-assisted adult cardiac surgery program. J Thorac Cardiovasc Surg. 2016;152(1):9–13.CrossRef Rodriguez E, Nifong WL, Bonatti J, Casula R, Falk V, Folliguet TA, Kiaii BB, Mack MJ, Mihaljevic T, Smith JM, Suri RM, Bavaria JE, MacGillivray TE, Chitwood WR Jr. Pathway for surgeons and programs to establish and maintain a successful robot-assisted adult cardiac surgery program. J Thorac Cardiovasc Surg. 2016;152(1):9–13.CrossRef
15.
go back to reference Chitwood WR Jr. Robotic mitral valve repair: how I teach it. Ann Thorac Surg. 2019;107(5):1297–301.CrossRef Chitwood WR Jr. Robotic mitral valve repair: how I teach it. Ann Thorac Surg. 2019;107(5):1297–301.CrossRef
16.
go back to reference Balkhy HH, Wann LS, Krienbring DJ, Arnsdorf SE. Integrating coronary anastomotic connectors and robotics toward a totally endoscopic beating heart approach: review of 120 cases. Ann Thorac Surg. 2011;92:821–7.CrossRef Balkhy HH, Wann LS, Krienbring DJ, Arnsdorf SE. Integrating coronary anastomotic connectors and robotics toward a totally endoscopic beating heart approach: review of 120 cases. Ann Thorac Surg. 2011;92:821–7.CrossRef
Metadata
Title
Robotic cardiac surgery impact of a new patient-side assistant on outcomes
Authors
Mackenzie McCrorey
Hiroto Kitahara
Dorothy Krienbring
Brooke Patel
Sarah Nisivaco
Husam H. Balkhy
Publication date
01-01-2020
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 1/2020
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-019-01165-9

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