EACTS Expert Consensus Document on Robotic Cardiac Surgery Minimum Standards for Programme Implementation, Training and Quality Assurance, developed in collaboration with EACTAIC and EBCP.

Authors

Wouter Oosterlinck, Meindert Palmen, Monica Gianoli, Milan Milojevic, Jan Bekaert, Friedhelm Beyersdorf, Filip P A Casselman, Karlien Degezelle, Volkmar Falk, Thierry Folliguet, Ulrich Franke, Pavel Hedvicak, Danny F Hoogma, Jörg Kempfert, Bonnie Kyle, Tom Melvin, Daniel Pereda, Paola Quattroni, Ricard Navarro-Ripoll, Emmanuel Vander Poorten, Johannes O Bonatti, Stepan Cerny, EACTS Scientific Document Group

Published in

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. Volume 68. Issue 10. Oct 07, 2026.

Abstract

Robotic cardiac surgery is entering a renewed phase of adoption, supported by growing clinical experience, evolving robotic platforms, and rising demand for less invasive procedures and faster recovery. However, implementation remains technically demanding and resource-intensive and can expose patients to avoidable harm when initiated without a structured training programme, clear technical standards, and rigorous outcome monitoring. This expert consensus document summarizes the current state of robotic cardiac surgery and defines requirements for the safe, effective, and sustainable development of robotic cardiac programmes. It addresses the current regulatory environment for surgical robots and accessories and proposes minimum requirements for hardware, software, and instruments for reconstructive intracardiac and coronary cardiac procedures. Furthermore, it outlines prerequisites for starting and developing training centres, including surgeon experience, multidisciplinary team composition, patient selection, and institutional infrastructure and volume considerations. A stepwise, competency-based training pathway is presented that integrates video and live case observation, virtual and simulation-based skills acquisition, wet/dry laboratory training, and proctored clinical implementation, ideally supported by dual-console systems. The document emphasises the need for transparent documentation and outcome benchmarking via a society-driven database to support quality assurance, learning-curve oversight, and continuous improvement. Finally, it highlights priorities for further research, including harmonized reporting standards, long-term and procedure-specific outcome evaluation, and prospective studies assessing training models, cost-effectiveness, and the incremental value of emerging technologies.

PMID:
42839657
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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