Total endoscopic computer enhanced coronary artery bypass grafting

Falk, Volkmar; Diegeler, Anno; Walther, Thomas; Banusch, J.; Brucerius, Jan; Raumans, Jörg; Autschbach, Rüdiger; Mohr, Friedrich W.

doi:10.1016/s1010-7940(99)00356-5

Cited by 263 publications

(146 citation statements)

References 17 publications

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“…Falk described the first off-pump robotic TECAB using an endoscopic stabilizing device in 2000. 11) A port access stabilizer was required to achieve TECAB, and thus an EndoWrist stabilizer was mounted on the fourth arm of the da Vinci surgical system. This suction-type endostabilizer gives the console surgeon complete control while offering better exposure and stabilization, and these have led to highly complex endoscopic procedures such as triple and quadruple CABG being performed on arrested and beating hearts.…”

Section: Tecabmentioning

confidence: 99%

Robot-Assisted Cardiac Surgery

Ishikawa

Watanabe

2015

ATCS

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The significant advantages of minimizing surgical trauma, such as reduced pain, shorter hospital stays, faster return to normal activities, and improved cosmesis, have resulted in the development of minimally invasive surgery. 1) Until recently, various difficulties associated with endoscopic approaches had stalled similar progress in the field of cardiac surgery. However, robotic technology overcame the difficulties associated with conventional endoscopic surgery and has made possible a new approach to minimally invasive cardiac surgery.The application of robot-assisted coronary surgery ranges from internal mammary artery (IMA) harvesting with handsewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB) either on-or off-pump. The bilateral IMAs can be harvested with the aid of a surgical robot, and then multivessel bypass grafting can follow. Srivastava calls such robot-assisted minimally invasive direct coronary artery bypass grafting (MIDCAB) "ThoraCAB.'' 2) Surgical robots can not only endoscopically harvest the IMA, but they can also anastomose the coronary artery in TECAB.On the other hand, closed-chest cardiopulmonary bypass (CPB) and cardioplegic arrest have stimulated the development of minimally invasive cardiac surgery (MICS) via a small thoracotomy, 3) and this has now become universal, especially to treat valve diseases and congenital structural heart diseases. Endoscopic techniques are also required for MICS, but conventional endoscopic instrumentation lacks the dexterity required for delicate cardiac surgical procedures, and the loss of depth perception caused by twodimensional monitors further increases operative obstacles.Surgical robots have been developed to enhance surgical ability and precision, and to repair structural heart conditions, including mitral valve plasty (MVP), atrial septal defect closure, cardiac tumour resection, ThoraCAB, and TECAB. The most common applications in cardiac surgery are MVP and endoscopic coronary artery bypass grafting (CABG). da Vinci Surgical SystemThe da Vinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA) comprises a surgeon's console, a Robot-Assisted Cardiac SurgeryNorihiko Ishikawa, MD, PhD and Go Watanabe, MD, PhD Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardi...

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Section: Tecabmentioning

confidence: 99%

Robot-Assisted Cardiac Surgery

Ishikawa

Watanabe

2015

ATCS

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“…The utilization of this method, in a revascularization surgery with mini-thoracotomy, reduces the pain in the postoperative period, probably because of less traction of the rib cage. In two different studies, utilizing the da Vinci system reported by MOHR et al [18] and by FALK et al [20], on average 64 ± 64 minutes and 61 ± 27 minutes were required for the dissection of the artery, but this time was reduce to 25 to 40 minutes, respectively, in the last cases of the series. Both demonstrated a mean functioning after anastomosis of greater than 95%.…”

Section: Robotic Surgerymentioning

confidence: 87%

Emprego de sistemas robóticos na cirurgia cardiovascular

Sant’Anna

Prates

Sant'Anna

et al. 2004

Rev Bras Cir Cardiovasc

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The development of robotic systems for surgery started in the 1980s, motivated by the US army's requirement of surgical procedures in combat areas with the surgeon in a distant place (telepresence). But the first human application of robotic surgery occurred in a robotic surgery, years later.Cardiac surgeons were attracted by the robotic techniques due to the potential reduction in the invasive character of the procedures. This results in reduced trauma, fast recovery and low cost of surgery. Robotic systems were developed, allowing totally thoracoscopic cardiac surgery for myocardial revascularization and multi-site pacemaker implant in selected cases. Support systems for videothoracoscopic also exist and may give support to internal thoracic artery harvesting, mitral valve reconstruction correction of congenital heart defects. We have used the AESOP ® system, with HERMES ® voice control, to harvest the internal thoracic arteries, trans-thoracic implantation of left ventricular electrodes and to correct congenital heart defects.In spite of scientific enthusiasm relating to robotic surgery, there is no clear evidence of superiority of this technique if compared to conventional procedures in terms of results. The same is true with the cost of the procedures as even if a single robotic surgery is less expensive, the initial investment for a complete robotic system (console, video control, instruments) can only be compensated with many procedures. But there is no doubt that robotic surgery will have a place in the future of surgery, providing telepresence of the surgeon, allowing teaching and training and performing less invasive surgical procedures. Descriptors: Robotics. Cardiac surgical procedures, methods. Surgical procedures, minimally invasive. Resumo

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“…Excellent outcomes have been observed in large series (1)(2)(3). Most recently, robotic surgical systems providing true three-dimensional (3-D) vision via dualcamera endoscopes, coupled with multi-jointed microinstrumentation enabling multiple degrees of freedom in range of motion, have been utilized to conduct coronary revascularization (4,5), mitral valve repair (4), atrial septal defect closure (6), left ventricular pacing lead implantation (7) and aortic valve surgery (8). The development of this surgical approach, the advantages, the cardiac surgical applications, the limitations and the potential future applications are discussed here.…”

Section: Introductionmentioning

confidence: 99%

Robotic cardiac surgery

Woo

2006

Robotics Computer Surgery

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Background Cardiac surgery, traditionally conducted via median sternotomy, has been recently forwarded by progressively advanced technology facilitating sternal-sparing minimally invasive, access to the heart. Robotic systems, comprised of miniaturized surgical instruments mounted on long thin shafts with multiple degrees of range of motion coupled with a dual camera endoscope providing true three-dimentional high-magnification visualization have greatly propelled this field.

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Total endoscopic computer enhanced coronary artery bypass grafting

Cited by 263 publications

References 17 publications

Robot-Assisted Cardiac Surgery

Robot-Assisted Cardiac Surgery

Emprego de sistemas robóticos na cirurgia cardiovascular

Robotic cardiac surgery

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