Robotic techniques improve quality of life in patients undergoing atrial septal defect repair.
BACKGROUND
Minimally invasive cardiac surgery has emerged as an alternative to conventional, open surgery. Although most studies of robotically assisted cardiac surgery have reported morbidity and mortality, few have addressed outcome measures, such as pain and quality of life, which was the aim of this study.


METHODS
Eleven patients with atrial septal defects (ASD), and five patients with patent foramen ovale, underwent repair using the Da Vinci system (Intuitive Surgical, Mountain View, CA). The Medical Outcomes Study Short Form Survey (SF-36), along with two additional questions, were administered to these patients on postoperative day 30, along with a similar number of patients who underwent ASD repair by mini-thoracotomy or sternotomy. Quality of life endpoints included bodily pain, vitality, mental health, general health, physical function, and social function.


RESULTS
Robotic patients demonstrated significantly higher scores in 6 of the eight variables (p < 0.05). There was no significant difference in intensive care unit or overall hospital stay among the groups (p = NS). Robotic patients returned to work after 40.2 +/- 30.2 days, mini-thoracotomy patients after 45.6 +/- 27.9 days, and sternotomy patients after 51.7 +/- 40.2 days (p = 0.767). There were no significant differences in SF-36 scores between patients who underwent mini-thoracotomy and sternotomy approaches.


CONCLUSIONS
Closure of an ASD can be performed safely and effectively via an endoscopic approach. Robotic technology minimized the degree of invasiveness, hastened postoperative recovery, and improved quality of life, although length of hospital stay was unchanged.
Morgan
Jeffrey A
JA
Department of Surgery, Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. jm2240@columbia.edu
Peacock
Joy C
JC
Kohmoto
Takushi
T
Garrido
Mauricio J
MJ
Schanzer
Bella M
BM
Kherani
Aftab R
AR
Vigilance
Deon W
DW
Cheema
Faisal H
FH
Kaplan
Sadi
S
Smith
Craig R
CR
Oz
Mehmet C
MC
Argenziano
Michael
M
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D004724:Endoscopy; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain; D011183:Postoperative Complications; D011788:Quality of Life; D012371:Robotics; D013249:Sternum / Q000601:surgery; D011795:Surveys and Questionnaires; D013908:Thoracotomy