Current State of Robotically Assisted Coronary Artery Bypass Surgery

A comprehensive multimodality heart motion prediction algorithm for robotic‐assisted beating heart surgery

“…Robotic‐assisted coronary artery bypass graft (CABG) surgery has been progressively developed over the past two decades. Thousands of successful CABG surgeries have been performed using the da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) using three different surgical techniques: (a) totally endoscopic coronary artery bypass on arrested heart with cardiopulmonary bypass machine (TECAB on‐pump), (b) TECAB on confined heart with a heart stabilizer (TECAB off‐pump), and (c) robotic‐assisted internal mammary artery harvesting, followed by off‐pump anastomosis through minimally invasive direct coronary artery bypass (robotic MIDCAB) …”

“…The ultimate goal of robotic‐assisted CABG is to perform safe and effective coronary anastomoses using minimally invasive approaches in order to enhance the recovery process and minimize the trauma. Although cardiopulmonary bypass allows operating on an arrested heart, the peripheral cannulation and aortic clamping prolong the operation time and can cause complications such as groin wound infections and vascular injuries . With the TECAB off‐pump and robotic MIDCAB techniques, the coronary anastomoses are performed on a beating heart that is confined by a cardiac stabilizer.…”

Feasibility of infrared tracking of beating heart motion for robotic assisted beating heart surgery

“…As a result, the surgery is performed practically on a still heart, with a stabilized view of the heart provided either by a camera fixed to the robotic arm, or by pure image processing . During operation, the surgeon uses the robot to localize the coronary target, incise the epicardium overlying the artery, perform arteriotomy, and suture anastomose the harvested internal mammary graft, which has been beveled at its distal end …”

“…This method is now frequently utilized by experienced surgeons, manually or by using robots, to treat patients of higher risk. Robotic assisted off‐pump CABG procedures are carried out using two defined surgical techniques: robotic assisted totally endoscopic coronary artery bypass (TECAB off‐pump); and robotic assisted anastomosis through minimally invasive direct coronary artery bypass (robotic MIDCAB) . However, in spite of using heart stabilizers, the surgical procedure is challenging, considering the fact that the residual heart motion is still significant in comparison with the 100 μm spatial precision required for CABG .…”