title: Robotic endovascular surgery.
abstract: The purpose of this review is to compare conventional endovascular procedures and the robotic endovascular approach in aortic aneurysm repair. Despite advantages over open surgery, conventional endovascular surgery has limitations. To develop an alternative, efforts have been focused on robotic endovascular systems. Two of the 3 studies comparing procedure times demonstrated reduced procedure time in the robotic group, by 6 times (p < 0.05). One study demonstrated that robotic procedures reduced fluoroscopic exposure time by 12 minute (p < 0.001). Three in-vitro studies showed that the number of movements required in robotic surgery was reduced up to 10 times (p < 0.05). One of 2 studies measuring robotic performance score showed a better performance score in the robotic endovascular group (p = 0.007). These results demonstrate that the robotic technique has multiple advantages over the conventional procedure, including improved catheter stability, a shorter learning curve, reduced procedure time, and better performance in cannulating tortuous vessels. However, robotic endovascular technology may be limited by the cost of the system, the size of the catheter, and the setup time required preoperatively. Further comparative studies between conventional and robotic approaches regarding cost-effectiveness, safety, and performance in cases involving complex anatomy and fenestrated stent grafts are essential. Nevertheless, this revolutionary technology is increasingly popular and may be the next milestone in endovascular surgery.
authors.affiliation: Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Au
authors.forename: Koel
authors.initials: K
authors.lastname: Ko
authors.forename: Josephine
authors.initials: J
authors.lastname: Tsang
authors.forename: Yiu Che
authors.initials: YC
authors.lastname: Chan
mesh_terms: D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015641:Radiography, Interventional; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Aortic diseases; blood vessel prosthesis implantation; endovascular procedures; robotics; vascular surgical procedures