title: Endoscopy-guided occlusion of secundum atrial defect permits use of smaller, cosmetically superior thoracotomy.
abstract: BACKGROUND
  Endoscopy has been introduced into cardiac surgery employing robotic systems. We have developed a new-minimally invasive approach that combines these two technologies for secundum atrial septal defect (ASD). The purpose of this study is to evaluate the efficacy of this approach, paying particular attention to its cosmetic effects.
  
  
  METHODS
  Between November 2004 and April 2006, 22 patients (aged 18 to 62) with ASDs (with sizes 10 to 39 mm) were treated with occlusion apparatus with endoscopy and robotic arm (AESOP 3000, Computer Motion Inc., Santa Barbara, CA, USA) assist.
  
  
  RESULTS
  All ASDs were successfully occluded with a mean device size of 26.8 mm (12 to 42 mm). Procedure time was ranged from 30 to 60 minutes. The ICU stay was less than 1 day and hospital stays was 3 to 7 days. No postoperative mortality was noted. During follow-up of 2 to 19 months, no major morbidities occurred.
  
  
  CONCLUSIONS
  Endoscopic ASD occlusion assisted with robotic is safe and effective with rapid recovery. The cosmetic effect is better results than conventional surgical repair.
authors.affiliation: Department of Cardiac Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhao.qiang@zs-hospital.sh.cn
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Sun
authors.forename: Anqing
authors.initials: A
authors.lastname: Chen
authors.forename: Limin
authors.initials: L
authors.lastname: Xia
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang M D
mesh_terms: D000293:Adolescent; D000328:Adult; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods*; D014463:Ultrasonography; D055815:Young Adult