Advantages and Complications of Using the Da Vinci Robotic System for Vascular Surgery

Objectives: The aim of our study was to evaluate the clinical experience with robot-assisted aortoiliac reconstruction for occlusive disease and aneurysm performed using the da Vinci™ system.
Methods: From November 2005 to August 2006, 40 patients were scheduled to undergo robot-assisted laparoscopic aortoiliac procedures. Thirty-six patients were prospectively evaluated for arterial occlusive disease (AOD), two patients for abdominal aortic aneurysm (AAA), one for common iliac artery aneurysm (CIAA) and one for combination of CIAA and AOD. Dissection of the aorta and iliac arteries were performed laparoscopically and the robotic system was used to construct the anastomosis, for the thrombendarterectomy and for posterior peritoneal suturing.
Results: Thirty-eight of 40 procedures (95%) were successfully completed robotically, while two were converted. The median operative time was 242 min, with a median cross-clamp time of 56 min. The average anastomosis construction time was 28 min and blood loss was 445 ml. Thirty-day survival was 100%, while mean ICU and hospital stays were 1.7 and 5.7 days, respectively. A regular oral diet was allowed after a mean 2.5 days.
Conclusions: Our clinical study confirms the safety and feasibility of robot-assisted laparoscopic vascular surgery. The main advantage of the da Vinci™ robotic system over standard laparoscopy lies in the construction of the vascular anastomosis and the reduction of aortic clamping times.