Robotic Vascular Surgery Procedures.
Petr Stadler, Prof., M.D., Ph.D..
Na Homolce Hospital, Praha 5, Czech Republic.
OBJECTIVES: The da Vinci system has been used by a variety of disciplines for laparoscopic procedures but the use of robots in vascular surgery is still relatively unknown. The feasibility of laparoscopic aortic surgery with robotic assistance has been sufficiently demonstrated. Our clinical experience with robot-assisted vascular surgery performed using the da Vinci system is herein described.
METHODS: Between November 2005 and August 2017, we performed 400 robot-assisted vascular procedures. 276 patients were prospectively evaluated for occlusive diseases, 94 patients for abdominal aortic aneurysm, 4 for a common iliac artery aneurysm, 7 for a splenic artery aneurysm, 1 for a internal mammary artery aneurysm, 6 for median arcuate ligament release, 8 for endoleak type II treatment post EVAR and 2 for renal artery reconstruction. Two cases were inoperable and 5 hybrid procedures in study were performed.
RESULTS: 386 cases (96,5%) were successfully completed robotically, one patient's surgery (0,25%) was discontinued during laparoscopy due to heavy aortic calcification. In 13 patients (3,2%) conversion was necessary. The thirty-day mortality rate was 0,25%, and early non-lethal postoperative complications were observed in six patients (1,5%).
CONCLUSIONS: Our experience with robot-assisted laparoscopic surgery has demonstrated the feasibility of this technique for occlusive diseases, aneurysms, endoleak II treatment post EVAR, for median arcuate ligament release and hybrid procedures.
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