The narrow field of view: challenges in sustaining a robotic open-heart program

Robotic coronary artery bypass grafting has struggled to be adopted over the last decade, in part because of a dichotomy between its quality and safety. The existing evidence is clear that robotic coronary artery bypass grafting (CABG) improves the morbidity and recovery time of this procedure. On the other hand, there have been persistent problems with the safety during early implementation. These problems can be overcome, but require a culture shift from the way that conventional CABG is often performed. The purpose of this manuscript is to outline the methods that will help generate this culture shift and enable robotic CABG to be more safe.