title: Trends in Robotic-Assisted Coronary Artery Bypass Grafts: A Study of The Society of Thoracic Surgeons Adult Cardiac Surgery Database, 2006 to 2012.
abstract: BACKGROUND
  Robotic technology is one of the most recent technological changes in coronary artery bypass graft (CABG) operations. The current analysis was conducted to identify trends in the use and outcomes of robotic-assisted CABG (RA-CABG).
  
  
  METHODS
  A retrospective analysis was performed using data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database between 2006 and 2012. Patient and site-level characteristics were compared between traditional CABG and RA-CABG. Operative death, postoperative length of stay, and postoperative complications were compared between the two groups.
  
  
  RESULTS
  The number of sites using RA-CABG remained relatively constant during the study period (from 148 in 2006 to 151 in 2012). The volume of RA-CABG as a percentage of the total CABG procedures increased slightly from 0.59% (872 RA-CABG of 127,717 total CABG) in 2006 to 0.97% (1,260 RA-CABG of 97,249 total CABG) in 2012. The RA-CABG patients were significantly younger (64 vs 65 years, p < 0.0001), had fewer comorbidities, and had lower rates of cardiopulmonary bypass use (22.4% vs 80.4%, p < 0.0001). RA-CABG patients had significantly lower unadjusted major complication rates (10.2% vs 13.5%, p < 0.0001), including postoperative renal failure (2.2% vs 2.9%, p < 0.0001), and shorter length of stay (4 vs 5 days, p < 0.0001). The difference in operative death was not significant (odds ratio, 1.10; 95% confidence interval, 0.92 to 1.30, p = 0.29).
  
  
  CONCLUSIONS
  RA-CABG use remained relatively stagnant during the analysis period despite lower rates of major perioperative complications and no difference in operative deaths. Additional analysis is needed to fully understand the role that robotic technology will play in CABG operations in the future.
authors.affiliation: Jefferson Clinical Research Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address: david.whellan@jefferson.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Whellan
authors.affiliation: Jefferson Clinical Research Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: McCarey
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Taylor
authors.affiliation: Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Todd K
authors.initials: TK
authors.lastname: Rosengart
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Amelia S
authors.initials: AS
authors.lastname: Wallace
authors.affiliation: Department of Surgery, Health Sciences Center, Stony Brook School of Medicine, Stony Brook, New York.
authors.forename: A Laurie W
authors.initials: AL
authors.lastname: Shroyer
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: James S
authors.initials: JS
authors.lastname: Gammie
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D012955:Societies, Medical; D015996:Survival Rate / Q000639:trends; D013903:Thoracic Surgery; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology