title: Adhesiolysis is facilitated by robotic technology in reoperative cardiac surgery.
abstract: Over a 2-year period, 5 patients who required reoperative chest surgery underwent robotic adhesiolysis with the da Vinci (Intuitive, Sunnyvale, CA) system. Resternotomy was performed under direct visualization for coronary revascularization (n = 2) or valve replacement (n = 1). A fourth patient required coronary revascularization after a previous axilloaxillary bypass. The final case involved the preparation of a substernal pathway for a gastric pull-up. In all cases adhesions were taken down without injury to the underlying structures. All grafts were preserved, and all patients recovered uneventfully. Robotic adhesiolysis is a versatile technique that allows careful lysis of adhesions and minimizes the risk of major complication during reoperative chest surgery.
authors.affiliation: Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York, USA. tpm2102@columbia.edu
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Martens
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Morgan
authors.forename: Marco M
authors.initials: MM
authors.lastname: Hefti
authors.forename: David A
authors.initials: DA
authors.lastname: Brunacci
authors.forename: Faisal H
authors.initials: FH
authors.lastname: Cheema
authors.forename: Satish K
authors.initials: SK
authors.lastname: Kesava
authors.forename: Steve
authors.initials: S
authors.lastname: Xydas
authors.forename: Nick C
authors.initials: NC
authors.lastname: Dang
authors.forename: Deon W
authors.initials: DW
authors.lastname: Vigilance
authors.forename: Takushi
authors.initials: T
authors.lastname: Kohmoto
authors.forename: Lyall A
authors.initials: LA
authors.lastname: Gorenstein
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D013249:Sternum / Q000473:pathology / Q000601:surgery*; D000267:Tissue Adhesions / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome