Establishing a New Minimally Invasive and Robotic Cardiac Surgery Program at a New Tertiary Care Centre: A Retrospective Analysis of our Experience and Results

Abstract

: Background : Over the past two decades, minimally invasive techniques have gained popularity in cardiac surgery that enable access to the heart via sternotomy free approaches for most adult procedures and isolated coronary artery bypass grafting. Here we present our experience and the strategies we used and the challenges we faced while starting a minimally invasive and robotic cardiac surgery program at a newly established tertiary care centre. Methods : We looked back at our methods and retrospectively analyzed our results of minimally invasive and robotic cardiac surgery in terms of morbidity and mortality and complications and other quality parameters like ICU stay and re-exploration rate etc as described later in detail. A step wise approach was adopted that introduced every team member to minimally invasive and robotic surgery in a gradual fashion slowly gaining confidence and increasing the complexity of the procedures. Results : 105 cases of minimally invasive and robotic cardiac surgery were performed over past one year. Out of these 92 were done by minimally invasive technique and 13 were done by robotic assistance. There was no mortality and none of the patient required any conversion to sternotomy or emergency bypass. One patient had to be re-explored for bleeding. The quality indicators were noted in terms of results and complications. Conclusion : Minimally invasive and robotic cardiac surgery is fast becoming procedure of choice across the world including in our country due to its many advantages in terms of early recovery, cosmesis and less blood product requirement but has got steep learning curve and is technically more difficult. So a gradual step wise technique with proper training and guidance has to be adopted to establish a successful program.