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A versatile tool for exposure in minimally invasive surgery.
E W Jansen1, E Duiveman, A P Ansems
1Department of Cardiothoracic Surgery of Utrecht Medical Center, Utrecht University, The Netherlands. E.Jansen@HLI.AZU.NL
Surgical Endoscopy
|October 10, 2001
Summary
A novel hydraulic arm provides essential stabilization for endoscopic surgery on the beating heart, enabling precise coronary artery bypass grafting. This tool enhances surgical site presentation and manipulation for complex procedures.
Area of Science:
- Minimally Invasive Surgery
- Cardiovascular Surgery
- Surgical Instrumentation
Background:
- Endoscopic surgery requires adequate space and instrument maneuverability within body cavities.
- Coronary artery grafting on a beating heart necessitates cardiac wall stabilization for precise surgical execution.
Purpose of the Study:
- To develop and evaluate a passive hydraulic arm for endoscopic surgery.
- To assess the arm's suitability for cardiac wall immobilization during beating heart coronary artery grafting.
Main Methods:
- A passive hydraulic arm was designed for operating table mounting, emphasizing versatility, durability, and stiffness.
- The arm's manipulation flexibility and stability were key development criteria.
- Suction fixation was employed for target site immobilization and presentation.
Main Results:
- The hydraulic arm demonstrated ease of manipulation and exceptional stiffness once positioned.
- Successful application in beating heart coronary artery bypass grafting (CABG) for multivessel revascularization was achieved.
- Effective cardiac wall stabilization and presentation facilitated accurate anastomosis suturing.
Conclusions:
- The developed hydraulic arm enables effective target site presentation and stabilization on the working heart.
- This instrument shows potential as a fundamental tool for advancing endoscopic cardiac surgical procedures.