A new exposure technique for the circumflex coronary artery system in robotic totally endoscopic coronary artery...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Robotic Surgery

Background:

• Isolated left main coronary artery stenosis presents a significant surgical challenge.
• Traditional coronary artery bypass grafting (CABG) requires sternotomy, leading to longer recovery times.
• Advancements in minimally invasive surgery offer potential alternatives.

Purpose of the Study:

• To report a case of completely endoscopic double coronary artery bypass grafting (CABG) for isolated left main coronary artery stenosis.
• To evaluate the feasibility of using the daVinci telemanipulation system and the Octopus-TE stabilizing device in this context.

Main Methods:

• A 53-year-old female patient with isolated left main coronary artery stenosis underwent a completely endoscopic double CABG procedure on an arrested heart.
• The daVinci telemanipulation system was used to suture a right internal mammary artery graft to the left anterior descending artery.
• The left internal mammary artery was connected to the first obtuse marginal branch, which was exposed using the Octopus-TE stabilizing device.

Main Results:

• The procedure involved a completely endoscopic double coronary artery bypass grafting (CABG).
• The daVinci system facilitated precise anastomosis of the right internal mammary artery graft.
• The Octopus-TE device aided in the exposure and grafting of the obtuse marginal branch.

Conclusions:

• Completely endoscopic coronary artery bypass grafting (CABG) is feasible for isolated left main coronary artery stenosis.
• The use of the daVinci telemanipulation system and Octopus-TE stabilizing device is effective for complex bypass grafting.
• This approach may facilitate the development of multivessel totally endoscopic CABG procedures.