HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nikolaos Bonaros Thomas Schachner Johannes Bonatti Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bonaros, N. Articles by Bonatti, J. Search for Related Content PubMed Articles by Bonaros, N. Articles by Bonatti, J. Related Collections Congenital - acyanotic Related Article

Ann Thorac Surg 2007;84:714
© 2007 The Society of Thoracic Surgeons

---

Correspondence

Reply

Innsbruck Medical University, Cardiac Surgery, Anichstrasse 35, Innsbruck, 6020 Austria

(Email: nikolaos.bonaros{at}uibk.ac.at).

To the Editor:

We would like to thank Dr Kumar [1] for his discussion and stimulating comments. We did not mention cost, as high costs for robotics are probably a well-known fact in the heart surgery community [2]. Cost-benefit calculations are also difficult; however a single center cost-benefit analysis provides evidence that the benefits of robotic surgery may justify investment in this new technology [3].

In our opinion, any comparisons with the standard sternotomy procedures are totally unjustified at this point of development, because all robotic cardiac surgery groups are still in their learning curves. Once the procedures are more standardized, quicker cost comparisons should be carried out, especially taking into account the potential benefits in the early rehabilitation phase [4]. A sternotomy patient will probably not resume every day activities during the second postoperative week, as the majority of our totally endoscopic-atrial septal defect repair patients who did become active at that time.

We congratulate Dr Kumar [1] on tremendously quick operating room times. Probably a huge number of atrial septal defect II patients are treated at their institution. Operating room time reduction is not the primary aim of our current program. Our goal is to develop complete endoscopic procedures in heart surgery, and the first successful steps have been taken using the daVinci telemanipulation system. We regard our longer operating room times as an investment into development of less destructive approaches to surgical treatment of heart disease. All of us are so used to the sternotomy that we may disregard its destructive and irreversible nature. The patient sees this very differently. Most young women are affected by atrial septal defect II in adulthood, and for them a port only approach is certainly an attractive offer. For all patients, preservation of thoracic and personal integrity is probably the most striking argument.

	References

Top References

 

1. Kumar AS. Robotic surgery(letter) Ann Thorac Surg 2007;84:714.[Free Full Text]
2. Bonaros N, Schachner T, Oehlinger A, et al. Robotically assisted totally endoscopic atrial septal defect repair: insights from operative times, learning curves, and clinical outcome Ann Thorac Surg 2006;82:687-694.[Abstract/Free Full Text]
3. Morgan JA, Thornton BA, Peacock JC, et al. Does robotic technology make minimally invasive cardiac surgery too expensive?A hospital cost analysis of robotic and conventional techniques. J Card Surg 2005;20:246-251.[Medline]
4. Morgan JA, Peacock JC, Kohmoto T, et al. Robotic techniques improve quality of life in patients undergoing atrial septal defect repair Ann Thorac Surg 2004;77:1328-1333.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nikolaos Bonaros Thomas Schachner Johannes Bonatti Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bonaros, N. Articles by Bonatti, J. Search for Related Content PubMed Articles by Bonaros, N. Articles by Bonatti, J. Related Collections Congenital - acyanotic Related Article