Novel sternum lifting technique for robotic internal thoracic artery graft harvesting

Internal thoracic artery (ITA) harvesting using the robotic system usually requires artificially induced capnothorax to provide visualization and working space, but this procedure has the disadvantage of deteriorating the hemodynamics. We developed an electrical sternum lifting system (ESLS) for robotic ITA harvesting, which is robust and can be finely adjusted, capable of lifting the sternum for a maximum of 5 to 10 cm. Using a mechanical sternum lifting device significantly (P < 0.01) shortened the time of ITA harvesting from a mean ± SD of 55.5 ± 24.1 minutes to 33.0 ± 15.7 minutes. No patient using the ESLS required induced capnothorax. Our novel ESLS provides a good operative field of view and allows ITA harvesting without inducing capnothorax.