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New instrument for robotic-enhanced skeletonized internal thoracic artery harvesting: triangular hook
Norihiko Ishikawa1, You Su Sun, L Wiley Nifong
1From the *Center for Robotics and Minimally Invasive Surgery, Brody School of Medicine at East Carolina University, Greenville, NC; and the †Department of Telesurgery and Geomedicine and the ‡Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
A new Triangular Hook instrument speeds up robotic skeletonization of the internal thoracic artery (ITA) during minimally invasive coronary surgery. This innovation makes the ITA harvesting procedure safer and more efficient.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Robotic Surgery Instrumentation
Background:
- Robotic surgery has advanced minimally invasive coronary artery bypass grafting.
- Instrumentation is key to improving these procedures.
- The internal thoracic artery (ITA) is crucial for coronary revascularization.
Purpose of the Study:
- To introduce and evaluate a novel instrument, the Triangular Hook.
- To assess its efficacy in expediting robotic skeletonization of the ITA.
- To determine if the instrument enhances the safety of the procedure.
Main Methods:
- Bilateral skeletonized ITA harvesting was performed in four dogs using the da Vinci surgical system.
- One ITA was harvested with the Triangular Hook, the contralateral ITA served as a control.
- Harvesting times were recorded and compared between the two methods.
Main Results:
- All eight ITAs were successfully harvested and remained patent post-procedure.
- Harvesting time was significantly reduced when using the Triangular Hook (41.5 ± 2.8 minutes) compared to conventional methods (47.5 ± 3.9 minutes).
- The difference in harvesting time was statistically significant (P = 0.02).
Conclusions:
- The Triangular Hook is a practical and safe instrument for robotic skeletonization of the ITA.
- This tool has the potential to improve efficiency in robotic minimally invasive coronary surgery.
- Further investigation into its clinical application is warranted.