Robotic Vascular Surgery
Petr Stadler, Sr., Petr Vitasek, Jr., Libor Dvoracek, Jr., Pavel Matous, Jr.
Na Homolce Hospital, Praha 5, Czech Republic
INTRODUCTION: The aim of this retrospective study was to describe and evaluate our single center experience with robotic aortic and non-aortic vascular surgery to treat mostly occlusive disease and aneurysms.METHODS:The authors present 540 robot assisted vascular operations (aortic and non-aortic). 347 patients were prospectively evaluated for occlusive disease, 139 patients for abdominal aortic aneurysm (AAA), 7 for a common iliac artery aneurysm, 11 for a splenic artery aneurysm, 1 for a internal mammary artery aneurysm, 17 patients for median arcuate ligament release, 13 for endoleak II treatment post endovascular aneurysm repair (EVAR), 2 for renal artery reconstruction and 3 cases were inoperable. 6 hybrid procedures in study were performed. RESULTS: 517 cases (95,7%) were successfully completed robotically, 3 patient's surgery (0,5%) was discontinued due to heavy aortic calcification and severe peri-aortitis respectively. In 20 patients (3,7%) conversion was necessary. The thirty-day mortality rate was 0,4% (2 patients), and early non-lethal postoperative complications were observed in 8 patients (1,5%). CONCLUSIONS:Our experience with robot-assisted laparoscopic surgery has demonstrated the feasibility of this technique for occlusive diseases, aneurysms, endoleak II treatment post EVAR, for median arcuate ligament release and hybrid procedures. The robotic system provides a real opportunity for minimally invasive surgery in the field of vascular surgery and offers true mini-invasive surgical vascular interventions with all its advantages. Robotic AAA treatment and aorto-femoral represent the standard operations in vascular surgery, and they are not only possible but also safe and successful. 
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