Document Detail


Robot-assisted computer enhanced closed-chest coronary surgery: preliminary experience using a Harmonic Scalpel and ZEUS.
MedLine Citation:
PMID:  11074972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Successful endoscopic harvesting of arterial conduits is critical to the performance of totally endoscopic bypass grafting. Recent success with computer-enhanced robotic systems in the performance of endoscopic single vessel coronary artery bypass (ENDOCAB) has paved the way for developing techniques for multivessel ENDOCAB. The Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) has previously demonstrated versatility and efficacy in manual endoscopic internal thoracic artery (ITA) harvesting. This study was undertaken to determine the feasibility of adapting this technology to a robotic telemanipulation system and its safety and efficacy in telerobotic ITA harvesting. METHODS: The Harmonic Scalpel was adapted to the ZEUS robotic surgical system (Computer Motion, Goleta, CA) and used to harvest the ITA in 19 patients undergoing multivessel off-pump coronary artery bypass (OPCAB) surgery. With the left lung collapsed, the ITA was harvested in all patients with CO2 insufflation through three 5 mm ports in the left chest. Postoperative angiography and transthoracic Doppler studies were performed in all patients. RESULTS: There were no ITA injuries and patients tolerated insufflation without hemodynamic compromise. Side branches were controlled easily without bleeding. Average ITA harvest time was 65 +/- 21 minutes. All vessels were patent after harvesting and demonstrated no angiographic evidence of injury. CONCLUSIONS: This paper demonstrates a technique by which the Harmonic Scalpel can be readily adapted to the ZEUS robotic telemanipulation system. Using this system, ITA's can be safely harvested totally endoscopically within a reasonable time frame for patients undergoing ENDOCAB.
Authors:
B Kiaii; W D Boyd; R Rayman; W B Dobkowski; S Ganapathy; G Jablonsky; R J Novick
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  3     ISSN:  1098-3511     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2000  
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-05-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  194-7     Citation Subset:  IM    
Affiliation:
London Health Sciences Centre, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Artery Bypass, Off-Pump / instrumentation*
Coronary Disease / radiography,  surgery*
Equipment Design
Female
Humans
Male
Middle Aged
Robotics*
Surgery, Computer-Assisted / instrumentation*
Thoracoscopy

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


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