Interruption of patent ductus arteriosus in children: robotically assisted versus videothoracoscopic surgery.
OBJECTIVE
If robotic surgery is to be widely used, the risks must be equivalent to those of standard techniques. This study analyzes the feasibility, safety, and efficiency of a robotically assisted technique for patent ductus arteriosus closure and compares the results with those of the videothoracoscopic technique.


METHODS
During 2000, 56 children weighing 2.3 to 57 kg (mean, 12 kg) underwent surgical closure of a patent ductus arteriosus. They were distributed into 2 groups: 28 patients (group 1) underwent the videothoracoscopic technique, and 28 (group 2) underwent a robotically assisted (Zeus; Computer Motion, Inc, Goleta, Calif) approach. Operative and postoperative surgical data were studied.


RESULTS
Operative time was significantly higher in the robotically assisted group. One conversion in videothoracoscopy was necessary, but no thoracotomy was required. Three persistent shunts were detected at postoperative echocardiography and were treated by means of application of a new clip with videothoracoscopy (1 in group 1 and 2 in group 2). No permanent laryngeal nerve injury and no hemorrhage were noted. The mean hospital stay was 3 days in both groups.


CONCLUSIONS
Robotically assisted closure of a patent ductus arteriosus is comparable with closure by means of the videothoracoscopic technique. However, it requires a longer operative time because of the increment in complexity.
Le Bret
Emmanuel
E
Institut Mutualiste Montsouris, Paris, France. emmanuel.lebret@imm.fr
Papadatos
Spiridon
S
Folliguet
Thierry
T
Carbognani
Daniel
D
Pétrie
Jean
J
Aggoun
Yacine
Y
Batisse
Alain
A
Bachet
Jean
J
Laborde
François
F
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011336:Probability; D011446:Prospective Studies; D012371:Robotics; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome