[The evolution of robotic cardiac surgery: state of the art and future perspectives]

In recent decades, there has been a growing interest in applying robotic technology to cardiac surgery. The advantages of robotic technology, such as magnified vision, precise robotic instruments and 360° movement of robotic arms, have attracted the cardiac community to reduce the invasiveness of the procedure, postoperative risks, and improve clinical outcomes. While in the United States the adoption of robotic assistance immediately gained widespread acceptance (approximately 1900 cases per year), in Europe the beginning has been slower with a significant growth in the last 10 years. The robotic platform has been used for various procedures, including mitral valve repair and replacement, coronary artery bypass grafting, arrhythmia ablation, aortic valve surgery, and tricuspid valve surgery. Intraoperative and postoperative results are encouraging showing good safety, a low mortality rate, a low conversion rate to larger incisions, shorter hospital stays compared to other techniques, and low postoperative complication rates. The procedure has also been effective, yielding good surgical quality and patient satisfaction. In this review, we analyze the current state of robotic cardiac surgery in the ever-evolving field of personalized cardiac surgery for each patient.