A disadvantage of port-access coronary artery bypass surgery using the da Vinci Robot compared with standard cardiopulmonary bypass revascularization is which of the following?

A disadvantage of port-access coronary artery bypass surgery using the da Vinci Robot compared with standard cardiopulmonary bypass revascularization is which of the following?

• A. Need for hypothermic cardiac arrest
• B. Greater incidence of intraoperative hypoxia
• C. Greater incidence of trauma to sternum
• D. Increased transfusion requirements

Answer: (B)

Exposure through a left-sided access with robotic assistance often requires one-lung ventilation and chest insufflation to expose the target vessels. This setup can transiently reduce oxygenation during the operation, making intraoperative hypoxia more likely than with standard on-pump CABG through sternotomy, where both lungs are ventilated and oxygenation is supported by the heart-lung machine throughout the procedure. The other options don’t reflect a disadvantage unique to port-access robotic CABG. There is no inherent need for hypothermic cardiac arrest in this approach, and when arrest is used it can be managed similarly to traditional methods. Traumatic injury to the sternum is less of a concern because the sternum is typically spared in port-access techniques. Transfusion requirements are not necessarily increased and may be similar or even reduced due to less extensive sternal injury and bleeding.

Exposure through a left-sided access with robotic assistance often requires one-lung ventilation and chest insufflation to expose the target vessels. This setup can transiently reduce oxygenation during the operation, making intraoperative hypoxia more likely than with standard on-pump CABG through sternotomy, where both lungs are ventilated and oxygenation is supported by the heart-lung machine throughout the procedure.

The other options don’t reflect a disadvantage unique to port-access robotic CABG. There is no inherent need for hypothermic cardiac arrest in this approach, and when arrest is used it can be managed similarly to traditional methods. Traumatic injury to the sternum is less of a concern because the sternum is typically spared in port-access techniques. Transfusion requirements are not necessarily increased and may be similar or even reduced due to less extensive sternal injury and bleeding.