Methods: Twenty-eight patients (15 males, 13 females; mean age 49.6±14.9 years; range 21 to 79 years) who underwent robotic and robotic-assisted cardiac surgery between March 2010 and March 2012 were retrospectively analyzed. Demographic data of the patients, type of surgery, anesthetic management, the amount of bleeding and transfusion, intraoperative and postoperative complications, duration of mechanical ventilation, length of intensive care unit and hospital stays were evaluated.

Results: Robotic-assisted left internal mammary artery harvesting was performed in six patients. All these six patients underwent single-vessel off-pump coronary artery bypass grafting surgery, five through mini-thoracotomy and one through sternotomy. A robotic pericardial window was created in one patient. Twenty-one patients underwent total robotic cardiac surgery through ports under cardiopulmonary bypass. There were no patient position or anesthesia-related complications. Only five patients were given blood and blood products. One patient underwent femoral embolectomy, while one patient required mini thoracotomy for bleeding management. Three patients underwent tube thoracostomy due to pleural effusion. The mean duration of discharge was 9.1±6.9 days.

Conclusion: In parallel to the developments in surgical techniques, anesthesiologists should also develop new anesthetic plan and management strategy for robotic surgery. Robotic and robotic-assisted cardiac anesthesia requires implementation of toracic and cardiac anesthesia principles and effective utilization of transesophageal echocardiography.