Robotic internal thoracic artery harvesting

Abstract

Purpose: Great progress has been made in robotic surgery, and several reports on robot-assisted coronary artery bypass grafting (CABG) have been published. Our team at Kanazawa University began using the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) in 2005. We report our experience of using the da Vinci Surgical System for totally endoscopic internal thoracic artery (ITA) harvesting.

Methods: Between December 2005 and May 2006, we used the da Vinci Surgical System to harvest the ITA through three ports placed on the left side of the chest in 10 patients.

Results: All 10 ITAs were harvested successfully in a skeletonized fashion. The robotic harvesting time was reasonable at 38.8 +/- 25.2 min, and the average length of harvested ITA was 16.2 +/- 3.1 cm. After computer-enhanced ITA harvesting, seven patients underwent off-pump CABG and three patients underwent minimally invasive direct CABG. There was no mortality, and the postoperative patency rate of all grafts was 100%.

Conclusions: The da Vinci Surgical System provides a high-resolution stereoscopic image and allows remote, tremor-free, and scaled control of endoscopic surgical instruments with seven degrees of freedom. Computer-enhanced ITA harvesting was performed safely with excellent results.