Evidence map›Paper›PMID 40642749›Full record

ArticleFrontiers in cardiovascular medicine2025

Small cuts, big questions: the impact of incision length in minimally invasive robotic cardiac surgery.

Thomas E Rubino, Ariana Jackson, Martin Winter, Kristian Punu, Syed Faaz Ashraf, Keith Dufendach, Nicholas Hess, Rachel Deitz, Stephen D Waterford, David Kaczorowski and 2 more

Abstract read
In one paragraph

Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Thomas E RubinoDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Ariana JacksonDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Martin WinterDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Kristian PunuDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Syed Faaz AshrafDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Keith DufendachDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Nicholas HessDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Rachel DeitzDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Stephen D WaterfordDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
David KaczorowskiDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Ibrahim SultanDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Johannes BonattiDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Evidence on incision lengths for ports and cardiopulmonary bypass (CPB) cannulation in robotic cardiac surgery is limited. This study aimed to assess these metrics and influencing factors. Methods: 204 patients underwent robotic mitral valve repair (MVR) (54.9%), totally endoscopic coronary artery bypass grafting (TECAB) (30.9%), and minimally invasive direct coronary artery bypass grafting (MIDCAB) (14.2%). Total incision length (TIL) was measured intraoperatively and defined as the sum of thoracic incisions, portholes, and incisions for cannulation. In both univariate and multivariate analyses, TIL was calculated based on demographic and intraoperative variables. Additionally, TIL was linked with postoperative outcomes. Results: The median length of thoracic access incisions and ports was 11.5 (5.0-51.0) cm, while for cannulation access, it was 5.0 (3.0-13.0) cm. The median total incision length was 16.5 (10.0-62.0) cm. Thirteen pre- and intraoperative variables were associated with TIL on univariate analysis. Multivariate analysis revealed that BMI ( Conclusions: Incision length in robotic cardiac surgery is primarily linked to obesity, procedure type, surgical technical problems, conversion to sternotomy, and procedure time. Longer incisions are associated with an increased number of blood transfusions and longer hospital stay.

Indexed as

cardiac surgery & percutaneous cardiovascular interventionsclinical outcomescoronary artery surgeryincision lengthMIDCABminimally invasive & robotic surgeryTECABvalve surgery

Identifiers

PMID40642749
PMCPMC12241096

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.