Robotic Coronary Artery Surgery - the Evolution of a New Minimally Invasive Approach in Coronary Artery Surgery[*]

Background: With the introduction of a wrist-enhanced robotic surgical system into minimally invasive cardiac surgery, the outlook of performing closed chest coronary artery bypass operations became a reality. Methods: Since May, 1999, this new wrist-enhanced instrumentation has been used in 109 (79 male, 30 female, median age 63 ± 9.9 years) patients. Seven suffering from single vessel coronary artery disease (SVD) and double vessel disease (DVD) were treated as totally endoscopic coronary artery bypass (TECAB). 60 with SVD underwent a wrist-enhanced, minimally invasive direct coronary artery bypass procedure. 25 with DVD were treated using the robotically enhanced Dresden Technique coronary artery bypass. Results: Survival was 100 %. In all patients the IMAs were safely harvested totally endoscopically. In the TECAB group, all patients were operated via a three-point stab incision. Data were observed during and after the operation. Conclusions: Our preliminary experiences with this new surgical technique for the robotically enhanced, minimally invasive treatment of coronary artery disease promote an optimistic way of thinking about the further development of these procedures.

- Minimally invasive coronary artery bypass - Endoscopic surgery - Robotics

References

• 1 Loulmet D, Carpentier A, d'Attelis N. et al . First Endoscopic Coronary Artery Bypass Grafting using Computer Assisted Instruments.  J Thorac Cardiovasc Surg. 1999;  118 4-10
• 2 Falk V, Diegeler A, Walther T, Bannusch J, Autschbach R, Mohr F W. Total Endoscopic Coronary Artery Bypass Grafting.  Eur J Cardiothorac Surg. 2000;  17(1) 38-45
• 3 Kappert U, Cichon R, Schneider J, Gulielmos V, Tugtekin S M, Matschke K, Schramm I, Schueler S. Closed Chest Coronary Artery Surgery on the Beating Heart Using a Robotic System. J Thorac Cardiovasc Surg (in press)
• 4 Kappert U, Cichon R, Schneider J, Schramm I, Gulielmos V, Schueler S. Closed Chest Bilateral Mammary Artery Grafting in Double Vessel Coronary Artery Disease. Ann Thorac Surg (in press)
• 5 Gulielmos V, Knaut M, Cichon R, Brandt M, Jost T, Matschke K, Schüler S. Minimally Invasive Surgical Treatment of Coronary Artery Multivessel Disease.  Ann Thorac Surg. 1998;  66 1018-1021
• 6 Gulielmos V, Brandt M, Knaut M, Cichon R, Wagner F M, Kappert U, Schüler S. The Dresden Approach for Complete Multivessel Revascularization.  Ann Thorac Surg. 1999;  68 1502-1505

1 Presented at the 3rd Joint Meeting of the German, Austrian, and Swiss Societies for Thoracic and Cardiovascular Surgery, Lucerne, February 9-12, 2000