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Early experience with robotic technology for coronary artery surgery
D H Boehm1, H Reichenspurner, H Gulbins
1Department of Cardiac Surgery and Institute for Surgical Research, University Hospital Munich-Grosshadern, Munich, Germany. boehm@hch.med.uni-muenchen.de
The Annals of Thoracic Surgery
|October 30, 1999
Summary
This study demonstrates that completely endoscopic coronary artery bypass grafting is feasible using robotic instruments and 3-D visualization. The technique was successfully applied to both arrested and beating hearts in clinical cases.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Endoscopic coronary bypass anastomoses require advanced instrumentation and visualization.
- Three-dimensional (3-D) visualization and robotic camera guidance are crucial for endoscopic procedures.
Purpose of the Study:
- To evaluate the feasibility of performing endoscopic coronary artery bypass anastomoses using robotic instrumentation.
- To assess the efficacy of the ZEUS surgical robotic system for coronary bypass grafting.
Main Methods:
- The study involved three phases: phantom model, animal experiments (dogs), and clinical application in patients.
- Robotic arms of the ZEUS system and voice-controlled endoscope positioning (AESOP) were utilized.
- Procedures included endoscopic harvesting of the left internal mammary artery (LIMA) and anastomosis to the left anterior descending artery (LAD) on arrested and beating hearts.
Main Results:
- Surgeons gained sufficient experience through phantom and animal studies for clinical application.
- Endoscopic LIMA-to-LAD anastomoses in patients ranged from 20 to 42 minutes.
- Median internal mammary artery flow rate was 74 mL/min; all patients had uneventful postoperative courses.
Conclusions:
- Completely endoscopic anastomosis of the left internal mammary artery to the left anterior descending artery is achievable with telemetric robotic technology.
- The technique is effective for both arrested and beating heart procedures.