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<p>Amid workforce shortages, the involvement of advanced practice providers, such as Japanese nurse practitioners (JNPs), in surgical roles has been increasing. JNPs have recently begun assisting in cardiovascular procedures, including robot-assisted coronary artery bypass grafting (RA-CABG); however, their clinical impact remains insufficiently characterized. This retrospective, single-center observational cohort study evaluated 199 consecutive patients who underwent RA-CABG using the left internal thoracic artery to left anterior descending artery technique between 2020 and 2023. Patients were stratified according to the type of bedside surgical assistant: physician as bedside assistant (<i>n</i> = 108) and JNP-assisted (<i>n</i> = 91). Outcomes assessed included operative time, robotic time, anastomosis time, intensive care unit (ICU) stay, postoperative complications, and learning curve analysis. Baseline characteristics were comparable between groups. The JNP-assisted group demonstrated significantly shorter operative time (<i>p</i> &lt; 0.001), robotic time (<i>p</i> &lt; 0.001), and anastomosis time (<i>p</i> = 0.005). No significant differences were observed in 30-day mortality,30-day graft patency, conversion to sternotomy, ICU stay, graft patency, or complication rates. In the JNP-assisted group, a significant negative correlation was observed between case number and operative time (Spearman’s ρ = −0.396, <i>p</i> &lt; 0.001), suggesting that the primary surgeon’s learning curve was preserved. The involvement of JNPs as bedside surgical assistants in RA-CABG was associated with improved operative efficiency without compromising patient safety or clinical outcomes. These findings support the role of JNPs as valuable members of multidisciplinary teams in advanced robotic cardiac surgery.</p>

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Impact of surgical assistance by Japanese nurse practitioners in robotic-assisted coronary artery bypass graft surgery

  • 期刊论文

  • 发表日期：

    2026年5月4日

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  • Tomoya Ohshiro,
  • Makoto Hashimoto,
  • Gentaku Hama,
  • Naohiro Wakabayashi,
  • Suguru Tatsuki,
  • McAndrew Merlini,
  • Keijirou Mitsube,
  • Kazutoshi Tachibana,
  • Yosuke Kuroda,
  • Ryuji Koshima

摘要

Amid workforce shortages, the involvement of advanced practice providers, such as Japanese nurse practitioners (JNPs), in surgical roles has been increasing. JNPs have recently begun assisting in cardiovascular procedures, including robot-assisted coronary artery bypass grafting (RA-CABG); however, their clinical impact remains insufficiently characterized. This retrospective, single-center observational cohort study evaluated 199 consecutive patients who underwent RA-CABG using the left internal thoracic artery to left anterior descending artery technique between 2020 and 2023. Patients were stratified according to the type of bedside surgical assistant: physician as bedside assistant (n = 108) and JNP-assisted (n = 91). Outcomes assessed included operative time, robotic time, anastomosis time, intensive care unit (ICU) stay, postoperative complications, and learning curve analysis. Baseline characteristics were comparable between groups. The JNP-assisted group demonstrated significantly shorter operative time (p < 0.001), robotic time (p < 0.001), and anastomosis time (p = 0.005). No significant differences were observed in 30-day mortality,30-day graft patency, conversion to sternotomy, ICU stay, graft patency, or complication rates. In the JNP-assisted group, a significant negative correlation was observed between case number and operative time (Spearman’s ρ = −0.396, p < 0.001), suggesting that the primary surgeon’s learning curve was preserved. The involvement of JNPs as bedside surgical assistants in RA-CABG was associated with improved operative efficiency without compromising patient safety or clinical outcomes. These findings support the role of JNPs as valuable members of multidisciplinary teams in advanced robotic cardiac surgery.