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Robotically enhanced coronary artery bypass surgery.

Y K Mishra1, H Wasir, M Sharma

  • 1Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, New Delhi. dryugal@yahoo.com

Indian Heart Journal
|March 9, 2005
PubMed
Summary
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Robotically enhanced surgery enables precise, totally endoscopic coronary artery bypass grafting. This advanced technique demonstrates high graft patency and shorter hospital stays for suitable patients.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Robotically enhanced telemanipulation surgery is an evolving technique for precise endoscopic cardiac procedures.
  • It offers high precision for both beating and arrested heart surgeries.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of robotically enhanced coronary artery bypass grafting.
  • To assess the efficacy of totally endoscopic coronary artery bypass surgery.

Main Methods:

  • 125 patients underwent robotically enhanced coronary artery bypass surgery using the da Vinci system.
  • 11 patients had totally endoscopic coronary artery bypass surgery (9 beating heart, 2 arrested heart).
  • Internal mammary artery harvest and anastomosis times were recorded; graft flow was measured.

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Main Results:

  • Totally endoscopic coronary artery bypass surgery showed 100% patency in 10 of 11 patients at 3 months.
  • Mean ICU stay was 1.2 days and mean hospital stay was 4.5 days, with 1 in-hospital mortality.
  • Endoscopic internal mammary artery takedown was performed in 114 patients, with 63 undergoing minimally invasive direct coronary artery bypass.

Conclusions:

  • Complete endoscopic anastomosis is feasible for single and suitable double vessel disease using telematic technology.
  • Robotics facilitates complete myocardial revascularization, including harvesting both internal mammary arteries.