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J Thorac Cardiovasc Surg 2007;134:559-561
© 2007 The American Association for Thoracic Surgery

Editorial

Robotics in cardiac surgery: The emperor’s new clothes

Washington University in St Louis School of Medicine/Barnes Jewish Hospital, Division of Cardiothoracic Surgery, St Louis, Mo.

Received for publication August 3, 2006; accepted for publication August 24, 2006.

^_* Address for reprints: Ralph J. Damiano Jr, MD, Washington University in St Louis School of Medicine/Barnes Jewish Hospital, Division of Cardiothoracic Surgery, 1 Barnes-Jewish Hospital Plaza, Suite 3108, Queeny Tower Campus Box 8234, St Louis, MO 63110. (Email: damianor@wustl.edu).

The first 20% of the full text of this article appears below.

"But he has nothing on at all," said a little child at last. "Good heavens! listen to the voice of an innocent child," said the father, and one whispered to the other what the child had said. "But he has nothing on at all," cried at last the whole people. That made a deep impression upon the emperor, for it seemed to him that they were right; but he thought to himself, "Now I must bear up to the end." And the chamberlains walked with still greater dignity, as if they carried the train which did not exist.

The Emperor’s New Clothes

Hans Christian Andersen, 1837

Robotic cardiac surgery was introduced clinically almost 10 years ago. In 1998, the first mitral and coronary artery bypass procedures were performed in Europe.^1-3 The first robotic coronary artery bypass grafting in North America was performed later the same year.⁴ Although this has been an exciting technology, it is time to look back after almost a decade of clinical experience and objectively examine whether it has lived up to its potential. In many ways, robotics has been a promise unfulfilled. The article in this issue of the Journal by De Canniere and coauthors⁵ illustrates some of the difficulties in applying robotic instrumentation to cardiac microsurgery.

Robotic instrumentation was introduced in the hope that it would enhance surgical ability and enable endoscopic microsurgery. Cardiac surgery was believed to be an ideal application for this advanced technology, because standard handheld endoscopic instruments, although adequate for excisional and resectional therapy, did not possess the requisite dexterity for reconstructive microsurgery. There was great hope that it would enable minimally invasive, . . . [Full Text of this Article]

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