Management of Anesthesia during Da Vinci Robot assisted Off-pump Coronary Artery Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONGDan-dan , DIAOYu-gang ,  SUNYing-jie , WANGHai-tao , ZHANGYi-nan , ZHANGTie-zheng

Department of Anesthesiology, General hospital of Shenyang Military command, Shenyang 110016, P. R. China;

Corresponding author：

SUNYing-jie, Email: sunyingjie9@hotmail.com

Keywords：

General anesthesia; Coronary artery bypass grafting; Da Vinci Surgical System

DOI：

10.7507/1007-4848.20160028

Video：

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Objective To summarize the management of anesthesia during robotic off-pump coronary artery bypass grafting (CABG) with the da Vinci surgical system in minimal thoractomy. Methods From May 2011 to December 2014, 24 patients (20 males and 4 females) at the average age of 62.1±12.8 years underwent robotic off-pump CABG with the da Vinci surgical system in our hospital. All the patients underwent the continuous invasive blood pressure monitoring, endotracheal intubation with the double-lumen tube after induction of general anesthesia, fiber bronchoscope positioning, intraoperative application of one-lung ventilation, placing the Swan-Ganz floating catheter, and monitoring the echocar-diography (TEE) and blood gas analysis and indexes of hemodynamics. Results All the patients were stable during the anesthesia induction period. There was no severe hypoxemia and hypercapnia. The surgery was successful and there was no thoracotomy. All the patients left off breathing machine postoperatively.The duration of mechanical ventilation was 5.3±2.8 hours. All patients were moved out from ICU in 18 hours.There was no thoracotomy for hemostasis after surgery. All the patients were discharged on the fourth or fifth day postoperatively. There was no death relevant to surgery or perioperative complications. There was no recurrence of cardiovascular events on the 30th day,3 months and 6 months postoperative follow-up. Conclusion This anesthesia method is safe and effective. It is a rapid recovery way with the fewer complications, less suffering of the patients, reliable anesthesia management and high satisfaction of the patients'.

Citation： SONGDan-dan, DIAOYu-gang, SUNYing-jie, WANGHai-tao, ZHANGYi-nan, ZHANGTie-zheng. Management of Anesthesia during Da Vinci Robot assisted Off-pump Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 124-127. doi: 10.7507/1007-4848.20160028 Copy

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1. 杨明, 高长青. 机器人心脏手术的应用现状. 中国微创外科杂志, 2012, 12(7): 586-590.
2. 王述民. 达芬奇机器人在肺癌根治术中的应用,现状及展望. 中国肿瘤, 2014, 23(9): 736-743.
3. 李瑾, 张成, 蒋会勇, 等. 应用达芬奇机器人手术系统辅助直肠癌前切除术11例体会. 中国普外基础与临床杂志, 2012, 19(12): 1319-1322.
4. 丁晓萍, 侯庆香, 刘蕊, 等. 机器人手术系统辅助妇科手术60例报告. 腹腔镜外科杂志, 2012, 17(10): 784-786.
5. 何威, 徐兆平, 祝宇, 等. 机器人辅助腹腔肾部分切除术治疗小肾癌的优势.临床泌尿外科杂志, 2013, 28(10): 721-724.
6. Mohr FW, Falk V, Diegeler A, et al. Computer-enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg, 1999, 117(6): 1212-1214.
7. 周琪, 王刚, 高长青, 等. 50例全机器人房间隔缺损修补术的麻醉方法总结. 中国体外循环杂志, 2009,7(1): 39-42.
8. 魏来, 沈金强, 夏利民, 等. 达芬奇机器人手术系统在51例心脏手术中的应用. 复旦学报(医学版), 2013,40(6): 699-704.
9. Czibik G, D'Ancona G, Donias HW, et al. Robotic cardiac surgery: Present and future applications. J Cardiothorac Vasc Anesth, 2002, 16(4): 495-501.
10. Cavallaro P, Rhee AJ, Chiang Y, et al. In-hospital mortality and morbidity after robotic coronary artery surgery. J Cardiothorac Vasc Anesth, 2015, 29(1): 27-31.
11. Adams C, Burns DJ, Chu MW, et al. Single-stage hybrid coronary revascularization with long-term follow-up. Eur J Cardiothorac Surg, 2014, 45(3): 438-442.
12. Donias HW, Karamanoukian HL, D'Ancona G, et al. Minimally invasive mitral valve surgery: from port access to fully robotic assisted surgery. Angiol, 2003, 54(1): 93-101.
13. Ganapathy S. Anaesthesia for minimally invasive cardiac surgery. Best Pract Res Clin Anaesthesiol, 2002, 16(1): 63-80.
14. D'Attellis N, Loulmet D, Carpentier A, et al. Robotic assisted cardiac surgery: anesthetic and postoperative considerations. J Cardiothorac Vasc Anesth, 2002, 16(4): 397-400.
15. Murkin JM, Ganapathy S. Anesthesia for robotic heart surgery: An over view. Heart Surg Forum, 2001, 4(4): 311-314.
16. Wang G, Gao C, Zhou Q, et al. Anesthesia management for roboti-cally assisted endoscopic coronary artery bypass grafting on beating heart. Innocation (Phila), 2010, 5(4): 291-294.
17. 张铁铮, 周锦, John Murkin, 等.机器人辅助心脏手术的麻醉.国外医学麻醉与复苏分册2005, 26(4): 235-239.
18. Wang G, Gao C, Zhou Q, et al. Anesthesia management of totally endoscopic atrial septal defect repair with a robotic surgical system. J Clin Anesth, 2011, 23(8): 621-625.
19. Chauhan S, Sukesan S. Anesthesia for robotic cardiac surgery: an amalgam of technology and skill. Ann Card Anaesth, 2010, 13(2): 169-175.
20. Campos JH. An update on robotic thoracic surgery and anesthesia. Curr Opin Anaesthesiol, 2010, 23(1): 1-6.
21. Lehmann A, Zeitler C, Lang J, et al. A comparison of the Arndt endobronchial blocker with a double lumen tube in robotic cardiac surgery. Anasthesiol Intensivmed Notfallmed Schmerzther, 2004, 39(6): 353-359.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Management of Anesthesia during Da Vinci Robot assisted Off-pump Coronary Artery Bypass Grafting

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