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Background <p>Robotic coronary artery bypass grafting (CABG) has been performed for more than 25 years, but the published evidence base is dispersed across single-center experience, registry analyses, and a small number of trials. A consolidated map of what has been studied, where, and which outcomes have been reported is needed to support clinical decision-making and guide future research. This study aimed to systematically map the published original literature on robotic CABG, characterizing study designs, geography, sample sizes, procedures, and the outcomes reported. A scoping review was conducted and reported in accordance with PRISMA-ScR. PubMed/MEDLINE, Scopus, Embase, and Google Scholar were searched from 1998 to October 2025; 69 additional records were identified from secondary sources. Records were de-duplicated in Covidence; two reviewers independently screened titles, abstracts, and full texts. Editorials, commentaries, reviews, meta-analyses, abstracts, operative-technique articles, laser-revascularization studies, and full texts that could not be retrieved were excluded.</p> Results <p>Of 3065 records identified, 2277 unique studies were screened, 595 underwent full-text review, and 369 met inclusion criteria. The evidence base was predominantly observational (cohort 64.8%; case report 17.1%; case series 15.7%); randomized trials accounted for only 1.9% (<i>n</i> = 7). Most studies were single-center (87.8%) and conducted in the United States (39.8%), Germany (8.7%), Canada, and Austria (each 7.9%). Sample sizes were highly skewed (median: 72, IQR: 12–234). TECAB was the most common procedure (43.4%), followed by robotic-assisted MIDCAB (39.0%) and hybrid coronary revascularization (13.0%). Some version of the da Vinci platform was used in 73.0% of studies; ZEUS accounted for 5.4%. Conduit use was dominated by the LIMA (84.8%); the RIMA was reported in 30.4%. In-hospital mortality was the most consistently reported outcome (69.6%); long-term graft patency (24.7%), economic outcomes (6.8%), and patient-reported outcomes (22.0%) were under-reported.</p> Conclusions <p>The published evidence on robotic coronary revascularization is abundant but methodologically uneven: the field is dominated by single-center cohort experience, with very few randomized trials and limited reporting of long-term, economic, and patient-reported outcomes. Future research should prioritize multicenter prospective studies, standardized core-outcome reporting, and direct comparison with conventional and minimally invasive alternatives.</p>

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Robotic coronary revascularization: a scoping review of the published evidence

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Amr A. Arafat,
  • Saud Alshehri,
  • Fatimah Alhijab,
  • Ahmed Elkhouly,
  • Rawan Alsaadi,
  • Raffay Rafiq,
  • Fatima Rafiq,
  • Jamala Selan,
  • Youssef Elmahrouk,
  • Sahar Alnasrallah,
  • Khaled A. Alotaibi,
  • Mohammed M. AlAklabi

摘要

Background

Robotic coronary artery bypass grafting (CABG) has been performed for more than 25 years, but the published evidence base is dispersed across single-center experience, registry analyses, and a small number of trials. A consolidated map of what has been studied, where, and which outcomes have been reported is needed to support clinical decision-making and guide future research. This study aimed to systematically map the published original literature on robotic CABG, characterizing study designs, geography, sample sizes, procedures, and the outcomes reported. A scoping review was conducted and reported in accordance with PRISMA-ScR. PubMed/MEDLINE, Scopus, Embase, and Google Scholar were searched from 1998 to October 2025; 69 additional records were identified from secondary sources. Records were de-duplicated in Covidence; two reviewers independently screened titles, abstracts, and full texts. Editorials, commentaries, reviews, meta-analyses, abstracts, operative-technique articles, laser-revascularization studies, and full texts that could not be retrieved were excluded.

Results

Of 3065 records identified, 2277 unique studies were screened, 595 underwent full-text review, and 369 met inclusion criteria. The evidence base was predominantly observational (cohort 64.8%; case report 17.1%; case series 15.7%); randomized trials accounted for only 1.9% (n = 7). Most studies were single-center (87.8%) and conducted in the United States (39.8%), Germany (8.7%), Canada, and Austria (each 7.9%). Sample sizes were highly skewed (median: 72, IQR: 12–234). TECAB was the most common procedure (43.4%), followed by robotic-assisted MIDCAB (39.0%) and hybrid coronary revascularization (13.0%). Some version of the da Vinci platform was used in 73.0% of studies; ZEUS accounted for 5.4%. Conduit use was dominated by the LIMA (84.8%); the RIMA was reported in 30.4%. In-hospital mortality was the most consistently reported outcome (69.6%); long-term graft patency (24.7%), economic outcomes (6.8%), and patient-reported outcomes (22.0%) were under-reported.

Conclusions

The published evidence on robotic coronary revascularization is abundant but methodologically uneven: the field is dominated by single-center cohort experience, with very few randomized trials and limited reporting of long-term, economic, and patient-reported outcomes. Future research should prioritize multicenter prospective studies, standardized core-outcome reporting, and direct comparison with conventional and minimally invasive alternatives.