Rubino Thomas E, Jackson Ariana, Winter Martin, Punu Kristian, Ashraf Syed Faaz, Dufendach Keith, Hess Nicholas, Deitz Rachel, Waterford Stephen D, Kaczorowski David, Sultan Ibrahim, Bonatti Johannes
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Front Cardiovasc Med. 2025 Jun 26;12:1575779. doi: 10.3389/fcvm.2025.1575779. eCollection 2025.
Evidence on incision lengths for ports and cardiopulmonary bypass (CPB) cannulation in robotic cardiac surgery is limited. This study aimed to assess these metrics and influencing factors.
204 patients underwent robotic mitral valve repair (MVR) (54.9%), totally endoscopic coronary artery bypass grafting (TECAB) (30.9%), and minimally invasive direct coronary artery bypass grafting (MIDCAB) (14.2%). Total incision length (TIL) was measured intraoperatively and defined as the sum of thoracic incisions, portholes, and incisions for cannulation. In both univariate and multivariate analyses, TIL was calculated based on demographic and intraoperative variables. Additionally, TIL was linked with postoperative outcomes.
The median length of thoracic access incisions and ports was 11.5 (5.0-51.0) cm, while for cannulation access, it was 5.0 (3.0-13.0) cm. The median total incision length was 16.5 (10.0-62.0) cm. Thirteen pre- and intraoperative variables were associated with TIL on univariate analysis. Multivariate analysis revealed that BMI ( = 0.003), procedure type ( < 0.001), conversion to sternotomy ( < 0.001), technical challenges ( = 0.034) and total procedure time ( < 0.001) were associated with extended incision length. Multivariate testing additionally showed an association of TIL with blood transfusion ( = 0.004) and hospital stay ( < 0.001).
Incision length in robotic cardiac surgery is primarily linked to obesity, procedure type, surgical technical problems, conversion to sternotomy, and procedure time. Longer incisions are associated with an increased number of blood transfusions and longer hospital stay.
关于机器人心脏手术中端口及体外循环（CPB）插管切口长度的证据有限。本研究旨在评估这些指标及影响因素。
204例患者接受了机器人二尖瓣修复术（MVR）（54.9%）、完全内镜下冠状动脉旁路移植术（TECAB）（30.9%）和微创直接冠状动脉旁路移植术（MIDCAB）（14.2%）。术中测量总切口长度（TIL），定义为胸部切口、端口及插管切口长度之和。在单因素和多因素分析中，TIL根据人口统计学和术中变量进行计算。此外，TIL与术后结果相关联。
胸部入路切口和端口的中位长度为11.5（5.0 - 51.0）cm，而插管入路的中位长度为5.0（3.0 - 13.0）cm。总切口长度的中位值为16.5（10.0 - 62.0）cm。单因素分析显示，13个术前和术中变量与TIL相关。多因素分析显示，体重指数（BMI）（= 0.003）、手术类型（< 0.001）、转为胸骨切开术（< 0.001）、技术挑战（= 0.034）和总手术时间（< 0.001）与切口长度延长相关。多因素检验还显示TIL与输血（= 0.004）和住院时间（< 0.001）相关。
机器人心脏手术中的切口长度主要与肥胖、手术类型、手术技术问题、转为胸骨切开术及手术时间有关。较长的切口与输血次数增加和住院时间延长相关。
