Excision of atrial myxoma using robotic technology.
OBJECTIVE
This study is to discuss a surgical approach for ideal and safe resection of atrial myxoma using the da Vinci S Surgical System (Intuitive Surgical, Inc, Sunnyvale, Calif).


METHODS
Nineteen consecutive patients underwent resection of atrial myxomas with the da Vinci S Surgical System. Mean age of the patients was 46 +/- 16 years. Mean tumor size was 45 x 5.5 cm. Fifteen tumors were in the left atrium, of which 11 tumors arose from the interatrial septum, 2 from the posterocaudal wall, 1 from the root of the anterior leaflet of the mitral valve, and 1 from the left atrial roof. In 13 patients, exploration was conducted through a left atriotomy anterior to the pulmonary veins and excision was achieved by dissecting a plane through the atrial muscle at the point of attachment. In the first 2 patients, exploration and excision were conducted through an oblique right atriotomy. Four tumors were in right atrium, all of which were resected from the beating heart. The da Vinci instrument arms were inserted through three 1-cm trocar incisions in the right side of the chest. Via 4 port incisions and a 1.5-cm working port, all the procedures were completed with a 30 degrees angled endoscope facing upward with the da Vinci S robot.


RESULTS
Resection was successful in all patients. There were no operative deaths, strokes, or other complications. All the patients were discharged. No recurrences of tumor or septal leakage were found in the complete 1- to 18-month follow-up.


CONCLUSIONS
The excision of atrial myxomas with the da Vinci S Surgical System is feasible, efficacious, and safe. Surgical results are excellent.
Minimally Invasive and Robotic Cardiac Surgery Center, Department of Cardiovascular Surgery, PLA General Hospital, Beijing, China. gaochq301@yahoo.com
Changqing
C
Gao
Ming
M
Yang
Gang
G
Wang
Jiali
J
Wang
Cangsong
C
Xiao
Yang
Y
Wu
Jiachun
J
Li
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult