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Robotic total endoscopic sutureless aortic valve replacement: proof of concept for a future surgical setting
Author(s) -
Vola Marco,
Maureira Pablo,
Kassir Radwan,
Fuzellier JeanFrançois,
Campisi Salvatore,
Doguet Fabien,
Albertini JeanNoel,
Ruggieri Vito Giovanni,
Folliguet Thierry
Publication year - 2016
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1694
Subject(s) - medicine , cadaver , aortic valve replacement , surgery , clamp , prosthesis , aortic valve , aortic root , aorta , radiology , computer science , stenosis , clamping , computer vision
Background Sutureless valves have recently enabled closed chest aortic valve replacement. This paper evaluates the feasibility of a robotic telemanipulation during thoracoscopic sutureless aortic valve implantation in cadavers. Methods Cadavers were prepared with a five thoracosopic trocar setting, with a transthoracic clamp inserted in the first right intercostal space and the optics inserted in the second. Seven sutureless valve implantations were scheduled using 5 Sorin Perceval and 2 Medtronic 3f Enable valves. Results In all cases performance of pericardial suspension, aortotomy and root exposure required less than 20 min. Native valve excision and sutureless bioprosthesis implantation was technically feasible in all cases. A satisfactory prosthesis sealing was ascertained visually and the absence of paravalvular leakages was assessed with a nerve hook test around the prosthetic flange. Conclusions Closed chest and robot assisted sutureless valve implantation is feasible in cadavers. Robotic technology can enhance reproducibility of the technique. Copyright © 2015 John Wiley & Sons, Ltd.