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Related Experiment Videos

Total endoscopic CABG using robotics on beating heart.

Tatiana Fleck1, Edda Tschernko, Doris Hutschala

  • 1Department of Cardiothoracic Surgery, Medical University Vienna, Vienna, Austria.

The Heart Surgery Forum
|August 23, 2005
PubMed
Summary
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Robotic totally endoscopic coronary artery bypass grafting (TECAB) on a beating heart is feasible. The learning curve demonstrated reduced operating times and safe clinical implementation with a moderate conversion rate.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Implementing robotic totally endoscopic coronary artery bypass grafting (TECAB) on a beating heart involves a learning process.
  • Initial training included cadaveric work and arrested heart procedures before transitioning to beating heart surgery in November 2003.

Purpose of the Study:

  • To evaluate the safety and learning curve of beating heart TECAB using the Da Vinci surgical system.
  • To assess procedural outcomes, including operating time and conversion rates.

Main Methods:

  • A prospective study of 14 patients with coronary artery disease undergoing beating heart TECAB from November 2003 to January 2005.
  • Data collected included patient demographics, operative details, and postoperative outcomes.

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Main Results:

  • The overall conversion rate was 35% (5/14) due to various complications.
  • Mean operating time decreased significantly throughout the study, from 342 minutes in the first 5 patients to 290 minutes in the last 4 patients.
  • Mean ICU and hospital stays were 1.3 and 8.4 days, respectively.

Conclusions:

  • Beating heart TECAB with the Da Vinci system can be safely implemented clinically.
  • Procedural efficiency improves with experience, indicated by decreasing operating times.
  • Effective team-console surgeon-robotic system interaction is key to successful implementation.