Closed chest coronary surgery. State of the art.

The so-called robotic systems have opened the era of closed-chest coronary surgery. We report the current status of the ongoing worldwide experience in the literature as the background of the present paper and address specifically some of the controversial aspects that are generated by this major paradigm shift which is introduced in the operating room. In conclusion we believe that, even though it is difficult to demonstrate incremental added value to a well established procedure such as coronary artery bypass graft (CABG), reducing the complications and cost of surgery accompany the implementation of the tools of new technologies. The added value of robotics to the therapeutic armamentarium in the treatment of coronary artery disease (CAD) may be worth the effort required for procedural development and the establishment of the learning curves. Only a thorough collection and presentation of the data from the early days will eventually demonstrate this added value for the patient and for the community before this technology spreads widely.