Document Detail


Early experience with robotic technology for coronary artery surgery.
MedLine Citation:
PMID:  10543565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To achieve an endoscopic coronary bypass anastomoses we performed a study with endoscopic robotic instrumentation and camera guidance using three-dimensional (3-D) visualization. METHODS: The surgical robotic system ZEUS (Computer Motion Inc, Goleta, CA) consists of three interactive robotic arms and a control unit allowing the surgeon to move the instrument arms in a scaled down mode. The third arm (AESOP, Computer Motion Inc, Goleta, CA) positions the endoscope via voice control. The study had three phases. Phase I: In a phantom model, end-to-side anastomoses between vein grafts and the left anterior descending coronary artery (LAD) of 109 pig hearts were performed. Phase II: In 6 dogs (FBI, 20-25 kg) the left internal mammary artery (LIMA) was harvested endoscopically. During Port-Access (Heartport Inc, Redwood City, CA) cardiopulmonary bypass (CPB), LIMA and LAD were then anastomosed endoscopically with the help of telemetric ZEUS instruments (Computer Motion Inc). Phase III: A total of seven patients were operated on with help of the ZEUS system (Computer Motion Inc). After endoscopic LIMA harvesting and CPB using the Port-Access (Heartport Inc) system, the bypass graft (LIMA to LAD) was anastomosed endoscopically through three thoracic ports in 2 patients. Another 3 patients were operated on off-pump with regional stabilization and 2 patients with sternotomy and routine CPB. RESULTS: The practice with the phantom model and the subsequent animal experiments allowed the surgeons to gain sufficient experience for the clinical setting. In the clinical cases, times for anastomoses ranged from 20 to 42 minutes. Median internal mammary artery flow rate was 74 mL per minute (range 36-110 mL per minute). One patient in the off-pump group was converted to CPB and routine anastomosis. All patients had an uneventful angiographic control and postoperative course. CONCLUSIONS: Using telemetic technology, a completely endoscopic anastomosis of LIMA to LAD is possible on the arrested heart, as well as on the beating heart.
Authors:
D H Boehm; H Reichenspurner; H Gulbins; C Detter; B Meiser; P Brenner; H Habazettl; B Reichart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  68     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-09     Completed Date:  1999-11-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1542-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery and Institute for Surgical Research, University Hospital Munich-Grosshadern, Munich, Germany. boehm@hch.med.uni-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / instrumentation*
Animals
Coronary Artery Bypass / instrumentation*
Dogs
Endoscopy*
Humans
Internal Mammary-Coronary Artery Anastomosis / instrumentation
Models, Cardiovascular
Myocardial Revascularization / instrumentation
Robotics*
Surgical Equipment
Swine
Telemetry / instrumentation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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