Robotically enhanced "Dresden technique" with bilateral internal mammary artery grafting

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Cardiac surgery continually aims to reduce operative trauma.
• Minimally invasive techniques are advancing coronary artery surgery.
• The Dresden Technique offers a foundation for improved surgical approaches.

Purpose of the Study:

• To evaluate the combination of the Dresden Technique with robotic endoscopic systems for coronary artery surgery.
• To assess the feasibility and outcomes of using bilateral internal mammary arteries (BIMA) harvested endoscopically.
• To introduce a novel treatment method for coronary artery disease (CAD) with reduced surgical trauma.

Main Methods:

• 25 patients with multivessel coronary artery disease (CAD) underwent surgery.
• Bilateral internal mammary arteries (BIMA) were harvested endoscopically using the da Vinci robotic system.
• The Dresden Technique was employed for arterial revascularization, connecting BIMA to coronary arteries.

Main Results:

• All 25 patients survived the procedure.
• The average surgery duration was 244 minutes.
• An average of 2.2 anastomoses were performed per patient, with one reexploration for bleeding (4%).

Conclusions:

• The integration of robotic endoscopic BIMA harvesting with the Dresden Technique represents a new treatment option for CAD.
• This combined approach facilitates arterial revascularization with substantially reduced surgical trauma.
• The method advances minimally invasive strategies in coronary artery bypass grafting.