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Surgery Grand Rounds - Downstate 2018

Grand rounds presentation provided an overview of robotic heart surgery.

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Robotic Heart Surgery
Robert Poston, MD
Chief, Division of Cardiothoracic Surgery
SUNY-Downstate, Brooklyn, NY
Surgery Grand Rounds - Downstate 2018
Surgery Grand Rounds - Downstate 2018
Surgery Grand Rounds - Downstate 2018
Surgery Grand Rounds - Downstate 2018
Surgery Grand Rounds - Downstate 2018

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INTESTINAL OBSTRUCTION.pptx...smart study..
 

Surgery Grand Rounds - Downstate 2018

  • 1. Robotic Heart Surgery Robert Poston, MD Chief, Division of Cardiothoracic Surgery SUNY-Downstate, Brooklyn, NY
  • 7. COMMON PRACTICE COMMON COMPLICATION Ultrasound probe Ultrasound image Partial cross clamp Aorta Aorta
  • 10. 10% 5% 1.6% 1970 1980 1990 2000 2010 INCIDENCE OF STROKE AFTER BYPASS GRAFTING OVER TIME
  • 12. ON-PUMP CABG MINIMALLY INVASIVE CABG/HYBRID
  • 13. Database n Stroke ref STS National Cardiac Database 2006-12 9862 0.5% Whellan D, ATS 2016 National Inpatient Sample 2009-10 2582 0.4% P Cavallaro, JTCVS 2015 National Inpatient Sample 2008-9 132 0% Anderson, JACS 2012 Meta-analysis of clinical trials 2002-15 8034 0.7% Cao C, Ann CT Surg 2016 NIH Observational trial 2012-13 200 0% Puskas, JACC 2016 TOTAL 20,810 0.5% Open CABG 155,012 1.8% 2017 STS- NCD report STROKES AFTER ROBOTIC CABG
  • 14. Recovery at 3 weeks Open CABG Robotic CABG P value Walking distance 0.5 ± 1.0 mi 1.7 ± 1.5 mi 0.04 Treadmill MVO2 (% baseline) 43% 93% NS 6 min walk test 57% 97% 0.02 Duke Activity Index 49% 98% 0.02 Faster Recovery after Robotic CABG Poston R. Wireless Technology Demonstrates that Physical Capabilities in the Early Phase of Recovery are Enhanced by Less Invasive, Robotic CABG, ISMICS oral presentation, 2015
  • 15. Epstein A, et al. Impact of Minimally Invasive Surgery on Medical Spending and Employee Absenteeism JAMA Surg. 2013;148(7):641-647. Quicker Return to Work after Robotic CABG
  • 16. Ann Thorac Surg 2018;106:691–5
  • 17. Hallinan JT. Wall Street Journal. June 21, 2005
  • 18. Impact of R-CABG on Postop Strokes • Hospital costs • Postacute care • Return to work • Malpractice premiums • Word of mouth reputation