Perioperative Patient Management in Mammary Coronary Bypass Surgery Using Da Vinci Surgical System
https://doi.org/10.24060/2076-3093-2023-13-1-27-32
Abstract
Introduction. Minimally invasive surgical techniques, including robot-assisted ones, on the one hand, allowed indications for surgery to be expanded, but on the other hand, generated a number of specific problems associated with technical aspects of minimally invasive treatment. The latter has led to a new consideration of the influence of surgical aggression on patients and showed a clear need for adequate anaesthetic support in order to correct homeostasis changes and ensure safety of patients. Aim. To improve the patient safety in mammary coronary bypass surgery using the Da Vinci robotic surgical system. Materials and methods. The study enrolled 12 patients who underwent robot-assisted endoscopic isolation of the left internal mammary artery, followed by an anastomosis of the anterior descending branch via a mini-thoracotomy in the fifth intercostal space under single lung sevoflurane inhalation anesthesia with continuous ESP analgesia. Results and discussion. No lethal outcomes or serious complications such as myocardial infarction and acute cerebrovascular accident were reported. Discharge or transfer to the rehabilitation unit was carried out on the 5th–7th day. Conclusion. Minimally invasive techniques, including robot-assisted ones, require that the intensivists and cardiac surgeons be aware of the pathophysiological factors that affect the cardiovascular and respiratory systems, and have the ability to predict the course of events and take actions to prevent complications.
About the Authors
A. F. NurimanshinRussian Federation
Almaz F. Nurimanshin — Cand. Sci. (Med.), Anesthesiology and Intensive Care Unit
Ufa
R. R. Bogdanov
Russian Federation
Rinat R. Bogdanov — Dr. Sci. (Med.), Assoc. Prof., Department of Anesthesiology and Resuscitation with a Course of Advanced Professional Education
Ufa
A. A. Khusaenova
Russian Federation
Albina A. Khusaenova — Cand. Sci. (Ped.), Assoc. Prof., Education Quality and Monitoring Office
Ufa
References
1. Vancheri F., Tate A.R., Henein M., Backlund L., Donfrancesco C., Palmieri L., et al. Time trends in ischaemic heart disease incidence and mortality over three decades (1990–2019) in 20 Western European countries: systematic analysis of the Global Burden of Disease Study 2019. Eur J Prev Cardiol. 2022;29(2):396–403. DOI: 10.1093/eurjpc/zwab134
2. Askarov R.A., Davletshin R.A., Askarova Z.F., Sharipova I.A. The level and structure of mortality from diseases of blood circulation system in the regions of the Republic of Bashkortostan (2002–2015). Health Care of the Russian Federation, Russian journal. 2017;61(6):300–8 (In Russ.). DOI: 10.18821/0044-197Х-2017-61-6-300-308
3. Glezer M. Stable coronary heart disease: diagnosis and treatment. Vrach. 2018;29(12):37–41 (In Russ.). DOI: 10.29296/25877305-201812-09
4. Drapkina O.M., Samorodskaya I.V. Trends in regional mortality rates from heart diseases in Russia in 2019–2021. Profilakticheskaya Meditsina. 2022;25(12):64–70 (In Russ.). DOI: 10.17116/profmed20222512164
5. Muradov A.G., Efendiev V.U., Andin A.V., Drobot D.B., Demidov D.P., Sakovich V.A. The history of coronary surgery development. Siberian Medical Review. 2021;3:15–25 (In Russ.). DOI: 10.20333/250001362021-3-15-25
6. Mick S., Keshavamurthy S., Bonatti J. Current status of minimally invasive, robotic and hybrid coronary artery bypass surgery. In: Taggart D., Abu-Omar Y. (eds) Core concepts in cardiac surgery. Oxford: Oxford Academic; 2018. Р. 53–72. DOI: 10.1093/med/9780198735465.003.0003
7. Yanagawa B., Puskas J.D. State-of-the-art surgical coronary revascularization: Multiple arterial conduits, minimal aortic manipulation. J Thorac Cardiovasc Surg. 2015;150(1):259–61. DOI: 10.1016/j.jtcvs.2015.02.030
8. Sedov V.M., Nemkov A.S. Vasilii Ivanovich Kolesov: pioneer of coronary surgery. Eur J Cardiothorac Surg. 2014;45(2):220–4. DOI: 10.1093/ejcts/ezt605
9. Chitwood W.R. Jr. Historical evolution of robot-assisted cardiac surgery: a 25-year journey. Ann Cardiothorac Surg. 2022;11(6):564–82. DOI: 10.21037/acs-2022-rmvs-26
10. Ashrafian H., Clancy O., Grover V., Darzi A. The evolution of robotic surgery: surgical and anaesthetic aspects. Br J Anaesth. 2017;119(suppl_1):i72–i84. DOI: 10.1093/bja/aex383
11. Bhatt H.V., Schuessler M.E., Torregrossa G., Fitzgerald M.M., Evans A.S., Narasimhan S., et al. Robotic cardiac surgery part ii: anesthetic considerations for robotic coronary artery bypass grafting. J Cardiothorac Vasc Anesth. 2020;34(9):2484–91. DOI: 10.1053/j.jvca.2019.11.005
12. Sepehripour A.H., Garas G., Athanasiou T., Casula R. Robotics in cardiac surgery. Ann R Coll Surg Engl. 2018;100(Suppl 7):22–33. DOI: 10.1308/rcsann.supp2.22
13. Wang G., Gao C. Robotic cardiac surgery: an anaesthetic challenge. Postgrad Med J. 2014;90(1066):467–74. DOI: 10.1136/postgradmedj-2013-132326
14. Ren Y., Zhu X., Yan H., Chen L., Mao Q. Cardiorespiratory impact of intrathoracic pressure overshoot during artificial carbon dioxide pneumothorax: a randomized controlled study. BMC Anesthesiol. 2022;22(1):76. DOI: 10.1186/s12871-022-01621-9
15. Rezk M.E., Elgazzar M.A., Abo Youssef S.M., Emeraa A.S., Elkafoury A.E., Moussa H.H. Open versus closed pleura internal mammary artery harvesting and early pulmonary function after coronary artery bypass grafting. Heart Lung Circ. 2020;29(9):1412–7. DOI: 10.1016/j.hlc.2019.09.014
16. Kapur A., Kapur V. Robotic surgery: anaesthesiologist’s contemplation. Malays J Med Sci. 2020;27(3):143–9. DOI: 10.21315/mjms2020.27.3.15
17. Kim K.N., Kim D.W., Jeong M.A., Sin Y.H., Lee S.K. Comparison of pressure-controlled ventilation with volume-controlled ventilation during one-lung ventilation: a systematic review and meta-analysis. BMC Anesthesiol. 2016;16(1):72. DOI: 10.1186/s12871-016-0238-6
18. Mittnacht A.C., London M.J., Puskas J.D., Kaplan J.A. Anesthesia for myocardial revascularization. In: Kaplan J.A. (ed). Kaplan's essentials of cardiac anesthesia. Elsevier; 2018. P. 322–51. DOI: 10.1016/B978-0323-49798-5.00014-0
Review
For citations:
Nurimanshin A.F., Bogdanov R.R., Khusaenova A.A. Perioperative Patient Management in Mammary Coronary Bypass Surgery Using Da Vinci Surgical System. Creative surgery and oncology. 2023;13(1):27-32. (In Russ.) https://doi.org/10.24060/2076-3093-2023-13-1-27-32