Robotic-Assisted Vascular Surgery: Current Landscape, Challenges, and Future Directions

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Vascular surgery evolved from open to endovascular techniques, each with trade-offs in invasiveness and durability.
• Laparoscopic surgery offered minimally invasive benefits but faced limitations.
• Robotic-assisted surgery emerges as a significant advancement, merging open surgery durability with minimally invasive recovery.

Purpose of the Study:

• To review current evidence on robotic applications in various vascular interventions.
• To assess the feasibility, outcomes, and future potential of robotic surgery in vascular care.

Main Methods:

• Systematic review of current evidence on robotic vascular surgery.
• Analysis of feasibility and outcomes across aortic, visceral, venous, and endovascular procedures.
• Evaluation of endovascular robotics for catheter navigation and radiation exposure reduction.

Main Results:

• Feasibility demonstrated in over 1500 patients with low conversion rates (~5%) and mortality (1-3%).
• High long-term patency rates (>90%) reported for aortoiliac occlusive disease.
• Endovascular robotics significantly improves navigation precision and reduces radiation exposure (85-95%).

Conclusions:

• Robotic vascular surgery shows promising feasibility and outcomes, comparable to traditional methods.
• Barriers to adoption include cost, instrument limitations, and training needs.
• Future advancements like AI and augmented reality, alongside multicenter trials, are crucial for establishing robotics as a standard in vascular care.