title: Does body mass index affect outcomes in robotic-assisted coronary artery bypass procedures?
abstract: OBJECTIVE
  Obese patients pose unique technical challenges for minimal-access cardiac surgery. We sought to examine the effect of body mass index on short-term outcomes in robotic-assisted coronary surgery.
  
  
  METHODS
  From January 2010 to November 2011, a total of 110 consecutive patients underwent robotic-assisted coronary surgery at our institution. All patients had robotic-assisted mobilization of the left internal mammary artery. Some patients then underwent direct coronary anastomosis to the left anterior descending coronary artery via a left mini thoracotomy, whereas others had a complete robotic endoscopic procedure within the closed chest. The short-term outcomes of obese patients (n = 39), defined as body mass index greater than 30 kg/m, were compared with those of nonobese patients (n = 71).
  
  
  RESULTS
  Mean left internal mammary artery harvest time was longer in obese patients than in nonobese patients (51.03 vs 39.94 minutes; P = 0.007), as was overall operative time (218.15 vs 186.72 minutes; P = 0.034). There were no significant differences in mortality or major morbidity between obese and nonobese patients.
  
  
  CONCLUSIONS
  Obesity does not adversely affect short-term outcomes in robotic-assisted coronary surgery, although operative times are somewhat longer for these patients. Robotic-assisted coronary techniques can be safely pursued in obese patients.
authors.affiliation: Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, NY, USA. jhemli@nshs.edu
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Hemli
authors.forename: Lincoln S
authors.initials: LS
authors.lastname: Darla
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Panetta
authors.forename: Joan
authors.initials: J
authors.lastname: Jennings
authors.forename: Valavanur A
authors.initials: VA
authors.lastname: Subramanian
authors.forename: Nirav C
authors.initials: NC
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics; D016896:Treatment Outcome