Robotic totally endoscopic surgery for congenital cardiac anomalies
BACKGROUND: During the last decade totally endoscopic cardiac surgery became a reality in dedicated centers. Apart from totally endoscopic coronary bypass surgery and endoscopic mitral valve repair, totally endoscopic surgery for simple congenital cardiac anomalies is feasible. In this review we summarize the possibilities and the outcome of robotic surgery for congenital cardiac anomalies, and give an outline of future perspectives for the treatment of more complex cardiac congenital anomalies in a totally endoscopic fashion. METHODS: A PubMed search for the period 1990 to 2010 was conducted with the following key words: "robotic heart surgery", "endoscopic ASD", "robotic ASD", "congenital robotic surgery", "robotic VSD", "robotic patent ductus arteriosus". Additional information from our own database and experience concerning robotic cardiac surgery was included in this review. RESULTS: Several procedures for congenital cardiac anomalies have been performed endoscopically. Robotic ASD closure, endoscopical removal of dislocated Amplatzer devices, closure of patent ductus arteriosus and division of vascular rings are reported. After initial experimental experiences with VSD closure recently the first clinical cases have been reported. In experimental models even coarctation of the aorta has been repaired. CONCLUSIONS: Robotic cardiac surgery for congenital anomalies is feasible and represents an attractive option for selected patients. In the future, with further development and refinement of this technology, more complex congenital lesions will most likely be addressed with this approach.