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A new needle driver for minientry coronary artery bypass
Toshiya Ohtsuka1, Mikio Ninomiya, Takahiro Nonaka
1Department of Cardiovascular Surgery, Tokyo Metropolitan Fuchu General Hospital, Tokyo, Japan.
The Heart Surgery Forum
|March 17, 2005
Summary
A new needle driver facilitates coronary artery anastomosis during minimally invasive surgery. This device proved safe and effective in 10 patients, achieving successful graft patency without instrument-related injury.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Surgical Instrumentation
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
- Minimally invasive techniques aim to reduce surgical trauma and improve recovery.
- Facilitating precise suturing in small surgical fields remains a challenge.
Purpose of the Study:
- To evaluate the clinical experience with a newly developed needle driver.
- To assess its utility in performing coronary artery anastomosis via minithoracotomy or port-access.
- To determine if the running suture technique can be effectively employed with this device.
Main Methods:
- A novel 21 cm, 38g needle driver with a pencil-grip and finger-operated controls was used.
- The device allows grasping and driving fine sutures (7-0/8-0 monofilament) for coronary anastomosis.
- Ten consecutive patients underwent off-pump coronary artery bypass to the left anterior descending artery via minithoracotomy (4.2 cm average length).
Main Results:
- No instrument-related injuries occurred during any anastomosis.
- The average time for each anastomosis was 12 minutes (range: 8-18 minutes).
- Postoperative angiography confirmed graft patency in all 10 patients.
Conclusions:
- The new needle driver is a viable instrument for facilitating off-pump coronary artery anastomosis.
- It enables precise suturing in minimally invasive approaches.
- Further clinical experience is warranted to fully establish its role.