title: Robotic cardiac surgery: an anaesthetic challenge.
abstract: Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart. Intracardiac procedures require the aid of peripheral cardiopulmonary bypass via a minithoracotomy. Robotic cardiac surgery, however, poses challenges to the anaesthetist, as the obligatory one-lung ventilation (OLV) and CO2 insufflation may reduce cardiac output and increase pulmonary vascular resistance, potentially resulting in hypoxaemia and haemodynamic compromise. In addition, surgery requires appropriate positioning of specialised cannulae such as an endopulmonary vent, endocoronary sinus catheter, and endoaortic clamp catheter under the guidance of transoesophageal echocardiography. Therefore, cardiac anaesthetists should have a working knowledge of these systems, OLV and haemodynamic support.
authors: Department of Cardiovascular Anesthesiology, PLA Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors: Gang
authors: G
authors: Wang
authors: Department of Cardiovascular Anesthesiology, PLA Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors: Changqing
authors: C
authors: Gao
mesh_terms: D000777:Anesthetics / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002408:Catheters, Indwelling; D017548:Echocardiography, Transesophageal; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D017410:Practice Guidelines as Topic; D012371:Robotics
chemical_list: D000777:Anesthetics
keywords: anaesthesia managment; da Vinci surgical system; manipulation technique; minimally invasive surgery; robotic cardiac surgery