title: Patient body image, self-esteem, and cosmetic results of minimally invasive robotic cardiac surgery.
abstract: BACKGROUND
  Patient-reported outcome measures reveal the quality of surgical care from the patient's perspective. We aimed to compare body image, self-esteem, hospital anxiety and depression, and cosmetic outcomes by using validated tools between patients undergoing robot-assisted surgery and those undergoing conventional open surgery.
  
  
  METHODS
  This single-center, multidisciplinary, randomized, prospective study of 62 patients who underwent cardiac surgery was conducted at Hospital from May 2013 to January 2015. The patients were divided into two groups: the robotic group (n = 33) and the open group (n = 29). The study employed five different tools to assess body image, self-esteem, and overall patient-rated scar satisfaction.
  
  
  RESULTS
  There were statistically significant differences between the groups in terms of self-esteem scores (p = 0.038), body image scores (p = 0.026), overall Observer Scar Assessment Scale (p = 0.013), and overall Patient Scar Assessment Scale (p = 0.036) scores in favor of the robotic group during the postoperative period. Robot-assisted surgery protected the patient's body image and self-esteem, while conventional open surgery decreased these levels but without causing pathologies. Preoperative depression and anxiety level was reduced by both robot-assisted surgery and conventional open surgery. The groups did not significantly differ on Patient Satisfaction Scores and depression/anxiety scores.
  
  
  CONCLUSIONS
  The results of this study clearly demonstrated that a minimally invasive approach using robotic-assisted surgery has advantages in terms of body image, self-esteem, and cosmetic outcomes over the conventional approach in patients undergoing cardiac surgery.
authors.affiliation: Department of Cardiovascular Surgery Clinic, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: taneriyi@gmail.com.
authors.forename: Taner
authors.initials: T
authors.lastname: İyigün
authors.affiliation: Department of Cardiovascular Surgery Clinic, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kaya
authors.affiliation: Department of Plastic and Reconstructive Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sevil Özgül
authors.initials: SÖ
authors.lastname: Gülbeyaz
authors.affiliation: Department of Psychiatry, Bakirkoy Research and Training Hospital, Istanbul, Turkey.
authors.forename: Nurhan
authors.initials: N
authors.lastname: Fıstıkçı
authors.affiliation: Departments of Psychology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gözde
authors.initials: G
authors.lastname: Uyanık
authors.affiliation: Department of Cardiovascular Surgery Clinic, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Yılmaz
authors.affiliation: Department of Cardiovascular Surgery Clinic, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Onan
authors.affiliation: Department of Cardiovascular Surgery Clinic, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Korhan
authors.initials: K
authors.lastname: Erkanlı
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001828:Body Image; D002921:Cicatrix / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000523:psychology; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000523:psychology*; D012649:Self Concept
keywords: Body image; Cosmetic results; Incision site; Patient satisfaction; Scar; Self-esteem