Intraoperative Anesthetic and Surgical Concerns for Robotic Thoracic Surgery.

Robotic thoracic surgery continues to gain momentum and is emerging as the optimal method for minimally invasive thoracic surgery. As a rapidly advancing field, continued review of the surgical and anesthetic concerns unique to robotic thoracic operations is necessary to maintain safe and efficient practice. In this review, we discuss the intraoperative concerns as they pertain to pulmonary, esophageal, and mediastinal thoracic robotic operations.

Operational and Institutional Recommendations and Requirements for TAVR: A Review of Expert Consensus and the Impact on Health Care Policy.

When transcatheter aortic valve replacement (TAVR) was first approved for use in the United States in 2012, multiple leading surgical and cardiology societies were tasked with creating recommendations and requirements for operators and institutions starting and maintaining TAVR programs. Creation of this consensus document was challenging due to limited experience with this new technology, and a lack of robust centralized data that could be used to validate outcome measures and create benchmarks for self-assessment and improvement. Despite these limitations, this document provided government agencies a framework for regulation that ultimately determined requirements for Medicare payment for TAVR and therefore greatly determined how and where care was delivered for patients with aortic stenosis.

Does paravertebral blockade facilitate immediate extubation after totally endoscopic robotic mitral valve repair surgery?

Objective: Immediate extubation of select patients in the operating room after cardiac surgery has been shown to be safe and may result in improved hemodynamics and decreased cost perioperatively. The aim of this study was to evaluate whether the addition of paravertebral blockade (PVB) to general anesthesia facilitates extubation in the operating room in patients undergoing totally endoscopic robotic mitral valve repair (TERMR).

Methods: A review of 65 consecutive patients who underwent TERMR between January 2012 and June 2013 at a single institution was conducted.

A Prospective Randomized Study of Paravertebral Blockade in Patients Undergoing Robotic Mitral Valve Repair.

Objective: The aim of this study was to evaluate the addition of paravertebral blockade to general anesthesia in patients undergoing robotic mitral valve repair.

Design: A randomized, prospective trial.

Setting: A single tertiary referral academic medical center.

Preoperative localization in primary hyperparathyroidism.

Objective: To determine the most effective preoperative localization techniques for patients with primary hyperparathyroidism to facilitate the surgical procedure, decrease patient morbidity, and decrease the number of repeat surgeries owing to inability to locate the abnormal parathyroid gland.

Methods: This was a retrospective study in which 53 patients with primary hyperparathyroidism underwent preoperative sestamibi scanning and ultrasonography. If the two tests failed to agree on the precise location of the abnormal gland, a third imaging technique, magnetic resonance imaging (MRI), was used to confirm the precise location of the gland.