| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2001;121:842-853
© 2001 The American Association for Thoracic Surgery
Evolving Technology |
From the Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany.
Received for publication May 4, 2000. Revisions requested July 27, 2000; revisions received Sept 14, 2000. Accepted for publication Nov 1, 2000. Address for reprints: Friedrich W. Mohr, MD, Klinik für Herzchirurgie, Universität Leipzig, Herzzentrum, Russenstraße 19, 04289 Leipzig, Germany (E-mail: mohf{at}medizin.uni-leipzig.de).
Objective: A computer-enhanced instrumentation system was used in 148 patients to minimize access in cardiac surgical procedures.
Methods: The da Vinci telemanipulation system (Intuitive Surgical, Mountain View, Calif) provides a high-resolution 3-dimensional videoscopic image and allows remote, tremor-free, and scaled control of endoscopic surgical instruments with 6 degrees of freedom. By April 2000, the system had been used in 131 patients for coronary artery bypass grafting and 17 patients for mitral valve repair. In the coronary bypass group, the system was used in one of three ways: (1) to take down the internal thoracic artery followed by a minimally invasive direct coronary bypass procedure (n = 81); (2) to perform the anastomosis between the internal thoracic artery and the left anterior descending coronary artery in standard-sternotomy coronary bypass (n = 15); or (3) for total endoscopic coronary artery bypass grafting to anastomose the left internal thoracic artery to the left anterior descending on the arrested heart (n = 27) or the beating heart (n = 8). In 17 patients with nonischemic mitral valve insufficiency the mitral valve was repaired. Closed-chest cardiopulmonary bypass with cardioplegic arrest (Port-Access technique; Heartport, Inc, Redwood City, Calif) was used for arrested-heart total endoscopic coronary bypass and mitral valve repair.
Results: The da Vinci system allows for precise tissue handling and enables the endoscopic performance of cardiac surgical tasks that require a high degree of dexterity (coronary anastomosis, mitral valve repair). No technical mishaps have occurred. The internal thoracic artery was successfully taken down in 79 of 81 patients in the group undergoing minimally invasive coronary bypass and, after a steep learning curve, is currently performed in less than 40 minutes. The postoperative patency rate is 96.3%. Total endoscopic coronary bypass was completed in 22 of 27 cases with 95.4% patency as demonstrated by angiography at 3 months' follow-up. Closed-chest endoscopic beating-heart bypass grafting was successfully performed in 2 out of 8 patients with the use of a new endoscopic stabilizer. In the group having mitral valve repair, primary endoscopic computer-enhanced repair was successfully completed in 14 of 17 patients; three others had to be changed to a standard endoscopic technique, including 1 who required valve replacement. At 3 months' follow-up, 1 additional patient underwent early reoperation for recurrent mitral insufficiency. Overall early and late mortality in this cohort of 148 patients was 2.0% and was not related to the use of the system.
Conclusion: In conclusion, computer-enhanced endoscopic cardiac surgery can be performed safely in selected patients. Internal thoracic artery takedown is now routinely performed with good results. Total endoscopic coronary bypass is feasible on the arrested heart but does not offer a major benefit over the minimally invasive direct approach because cardiopulmonary bypass is still required. The early clinical experience with closed-chest beating-heart bypass grafting outlines the limitations of this approach despite some procedural success.
This article has been cited by other articles:
|
|
 |
|
  T. Mihaljevic, A. M. Gillinov, C. Jarrett, L. Seto, R. Savage, and P. DeVilliers Endoscopic robotically-assisted mitral valve repair MMCTS, September 14, 2009; 2009(0914): 3608. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. R. Chitwood Jr., E. Rodriguez, M. W.A. Chu, A. Hassan, T. B. Ferguson, P. W. Vos, and L. W. Nifong Robotic mitral valve repairs in 300 patients: a single-center experience. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 436 - 441. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Reiley, T. Akinbiyi, D. Burschka, D. C. Chang, A. M. Okamura, and D. D. Yuh Effects of visual force feedback on robot-assisted surgical task performance J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 196 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. R. Chitwood Jr. and E. Rodriguez Minimally Invasive and Robotic Mitral Valve Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 1079 - 1100. [Full Text]
|
|
|
|
|
|
R. Waseda, N. Ishikawa, M. Oda, I. Matsumoto, Y. Ohta, N. Inaki, Y. Hirano, and G. Watanabe Robot-assisted endoscopic airway reconstruction in rabbits, with the aim to perform robot-assisted thoracoscopic bronchoplasty in human subjects. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 989 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. de Canniere, G. Wimmer-Greinecker, R. Cichon, V. Gulielmos, F. Van Praet, U. Seshadri-Kreaden, and V. Falk Feasibility, safety, and efficacy of totally endoscopic coronary artery bypass grafting: Multicenter European experience J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 710 - 716. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Smith, H. Stein, A. M. Engel, S. McDonough, and L. Lonneman Totally Endoscopic Mitral Valve Repair Using a Robotic-Controlled Atrial Retractor Ann. Thorac. Surg., August 1, 2007; 84(2): 633 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Oehlinger, N. Bonaros, T. Schachner, E. Ruetzler, G. Friedrich, G. Laufer, and J. Bonatti Robotic Endoscopic Left Internal Mammary Artery Harvesting: What Have We Learned After 100 Cases? Ann. Thorac. Surg., March 1, 2007; 83(3): 1030 - 1034. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Wisser, T. Fleck, D. Hutschala, and E. Wolner The 3rd hand - a simple but useful tool for beating heart total endoscopic coronary bypass grafting (BH-TECAB) Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 519 - 520. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Akpinar, M. Guden, E. Sagbas, I. Sanisoglu, B. Caynak, and Z. Bayramoglu Robotic-Enhanced Totally Endoscopic Mitral Valve Repair and Ablative Therapy Ann. Thorac. Surg., March 1, 2006; 81(3): 1095 - 1098. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Farhat, M. Vergnat, P. Blanc, P. Chiari, and O. Jegaden Which place for Port AccessTM surgery in coronary artery bypass grafting? A mid-term follow up study Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 71 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Pennington The Impact of New Technology on Cardiothoracic Surgical Practice Ann. Thorac. Surg., January 1, 2006; 81(1): 10 - 18. [Full Text] [PDF]
|
|
|
|
|
|
B. J. Park, R. M. Flores, and V. W. Rusch Robotic assistance for video-assisted thoracic surgical lobectomy: Technique and initial results J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 54 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Y. Loisance, K. Nakashima, and M. Kirsch Computer-assisted coronary surgery: lessons from an initial experience Interactive CardioVascular and Thoracic Surgery, October 1, 2005; 4(5): 398 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. DeRose Jr, S. K. Balaram, C. Ro, D. G. Swistel, V. Singh, J. R. Wilentz, G. J. Todd, and R. C. Ashton Mid-term results and patient perceptions of robotically-assisted coronary artery bypass grafting Interactive CardioVascular and Thoracic Surgery, October 1, 2005; 4(5): 406 - 411. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. W. Nifong, W.R. Chitwood, P.S. Pappas, C.R. Smith, M. Argenziano, V.A. Starnes, P.M. Shah, and for the Multi-center Robotic Mitral Repair Group Robotic mitral valve surgery: A United States multicenter trial J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1395 - 1404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. R. Chitwood Jr Current Status of Endoscopic and Robotic Mitral Valve Surgery Ann. Thorac. Surg., June 1, 2005; 79(6): S2248 - S2253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. A. Subramanian, N. U. Patel, N. C. Patel, and D. F. Loulmet Robotic Assisted Multivessel Minimally Invasive Direct Coronary Artery Bypass With Port-Access Stabilization and Cardiac Positioning: Paving the Way for Outpatient Coronary Surgery? Ann. Thorac. Surg., May 1, 2005; 79(5): 1590 - 1596. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Savitt, G. Gao, A. P. Furnary, J. Swanson, H. L. Gately, and J. R. Handy Application of Robotic-Assisted Techniques to the Surgical Evaluation and Treatment of the Anterior Mediastinum Ann. Thorac. Surg., February 1, 2005; 79(2): 450 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Reiter, U. Reiter, P. Bergmann, and R. Rienmuller MR imaging-based port placement planning for totally endoscopic coronary artery bypass grafting Interactive CardioVascular and Thoracic Surgery, June 1, 2004; 3(2): 341 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Ewing, A. Pigazzi, Y. Wang, and G. H. Ballantyne Robots in the Operating Room The History Surgical Innovation, June 1, 2004; 11(2): 63 - 71. [Abstract] [PDF]
|
|
|
|
|
|
T. Carrel, L. Englberger, D. Keller, S. Windecker, B. Meier, and F. Eckstein Clinical and angiographic results after mechanical connection for distal anastomosis in coronary surgery J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1632 - 1640. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Hashizume and K. Tsugawa Robotic Surgery and Cancer: the Present State, Problems and Future Vision Jpn. J. Clin. Oncol., May 1, 2004; 34(5): 227 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Bolotin, W. W. Scott Jr, T. C. Austin, P. J. Charland, A. P. Kypson, L. W. Nifong, K. Salleng, and W. R. Chitwood Jr Robotic skeletonizing of the internal thoracic artery: is it safe? Ann. Thorac. Surg., April 1, 2004; 77(4): 1262 - 1265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Morgan, J. C. Peacock, T. Kohmoto, M. J. Garrido, B. M. Schanzer, A. R. Kherani, D. W. Vigilance, F. H. Cheema, S. Kaplan, C. R. Smith, et al. Robotic techniques improve quality of life in patients undergoing atrial septal defect repair Ann. Thorac. Surg., April 1, 2004; 77(4): 1328 - 1333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. C. Saunders, E. A. Grossi, R. Sharony, C. F. Schwartz, G. H. Ribakove, A. T. Culliford, J. Delianides, F. G. Baumann, A. C. Galloway, and S. B. Colvin Minimally invasive technology for mitral valve surgery via left thoracotomy: Experience with forty cases J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 1026 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. P. Carrel, F. S. Eckstein, L. Englberger, P. A. Berdat, and J. Schmidli Clinical experience with devices for facilitated anastomoses in coronary artery bypass surgery Ann. Thorac. Surg., March 1, 2004; 77(3): 1110 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bonatti, T. Schachner, O. Bernecker, O. Chevtchik, N. Bonaros, H. Ott, G. Friedrich, F. Weidinger, and G. Laufer Robotic totally endoscopic coronary artery bypass: Program development and learning curve issues J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 504 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Filsoufi, R. S. Farivar, L. Aklog, C. A. Anderson, R. H. Chen, S. Lichtenstein, J. Zhang, and D. H. Adams Automated distal coronary bypass with a novel magnetic coupler (MVP system) J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 185 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Jacobs, D. Holzhey, B. B. Kiaii, J. F. Onnasch, T. Walther, F. W. Mohr, and V. Falk Limitations for manual and telemanipulator-assisted motion tracking--implications for endoscopic beating-heart surgery Ann. Thorac. Surg., December 1, 2003; 76(6): 2029 - 2035. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Damiano Jr Invited commentary Ann. Thorac. Surg., December 1, 2003; 76(6): 2035 - 2036. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ohtsuka, M. Ninomiya, T. Maemura, and S. Takamoto Needle-guided mini-entry in video-assisted coronary artery bypass Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 644 - 646. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Herzog, S. Dogan, T. Diebold, M. F. Khan, H. Ackermann, S. Schaller, T. G. Flohr, G. Wimmer-Greinecker, A. Moritz, and T. J. Vogl Multi-Detector Row CT versus Coronary Angiography: Preoperative Evaluation before Totally Endoscopic Coronary Artery Bypass Grafting Radiology, October 1, 2003; 229(1): 200 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Novick, S. A. Fox, B. B. Kiaii, L. W. Stitt, R. Rayman, K. Kodera, A. H. Menkis, and W. D. Boyd Analysis of the learning curve in telerobotic, beating heart coronary artery bypass grafting: a 90 patient experience Ann. Thorac. Surg., September 1, 2003; 76(3): 749 - 753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. D. Boyd and K. D. Stahl The Janus syndrome: a perspective on a new era of computer-enhanced robotic cardiac surgery J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 625 - 630. [Full Text] [PDF]
|
|
|
|
|
|
C. J. van Andel, P. V. Pistecky, and C. Borst Mechanical properties of porcine and human arteries: implications for coronary anastomotic connectors Ann. Thorac. Surg., July 1, 2003; 76(1): 58 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Giulianotti, A. Coratti, M. Angelini, F. Sbrana, S. Cecconi, T. Balestracci, and G. Caravaglios Robotics in General Surgery: Personal Experience in a Large Community Hospital Arch Surg, July 1, 2003; 138(7): 777 - 784. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. K. von Segesser, P. Tozzi, M. Augstburger, and A. Corno Working heart off-pump cardiac repair (OPCARE) - the next step in robotic surgery? Interactive CardioVascular and Thoracic Surgery, June 1, 2003; 2(2): 120 - 124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Morgan, M. E. Ginsburg, J. R. Sonett, D. L.S. Morales, T. Kohmoto, L. A. Gorenstein, C. R. Smith, and M. Argenziano Advanced thoracoscopic procedures are facilitated by computer-aided robotic technology Eur. J. Cardiothorac. Surg., June 1, 2003; 23(6): 883 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Bacchetta, R. J. Korst, N. K. Altorki, J. L. Port, O. W. Isom, and C. A. Mack Resection of a symptomatic pericardial cyst using the computer-enhanced Da VinciTM surgical system Ann. Thorac. Surg., June 1, 2003; 75(6): 1953 - 1955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. W. Nifong, V. F. Chu, B. M. Bailey, D. M. Maziarz, V. L. Sorrell, D. Holbert, and W. R. Chitwood Jr Robotic mitral valve repair: experience with the da Vinci system Ann. Thorac. Surg., February 1, 2003; 75(2): 438 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Mehta, S. Goswami, M. Argenziano, C. R. Smith, and B. Mets Anesthesia for Robotic Repair of the Mitral Valve: A Report of Two Cases Anesth. Analg., January 1, 2003; 96(1): 7 - 10. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. J. Woo and T. J. Gardner Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607. [Full Text]
|
|
|
|
|
|
W. R. Chitwood Jr. and L. W. Nifong Minimally Invasive and Robotic Valve Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 1075 - 1092. [Full Text]
|
|
|
|
 |
|
 F. W. LoGerfo, D. J. Drenth, N. J.G.M. Veeger, P. W. Boonstra, G. D'Ancona, H. Karamanoukian, R. E. Dragu, W. C. Wood, H. Thiele, F. W. Mohr, et al. Minimally Invasive Bypass Surgery N. Engl. J. Med., December 26, 2002; 347(26): 2165 - 2168. [Full Text] [PDF]
|
|
|
|
|
|
I. Yoshino, M. Hashizume, M. Shimada, M. Tomikawa, and K. Sugimachi Video-assisted thoracoscopic extirpation of a posterior mediastinal mass using the da Vinci computer enhanced surgical system Ann. Thorac. Surg., October 1, 2002; 74(4): 1235 - 1237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Doll, M. A. Borger, J. Hain, J. Bucerius, T. Walther, J. F. Gummert, and F. W. Mohr Minimal access aortic valve replacement: effects on morbidity and resource utilization Ann. Thorac. Surg., October 1, 2002; 74(4): S1318 - 1322. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dogan, T. Aybek, S. Mierdl, and G. Wimmer-Greinecker Totally endoscopic coronary artery bypass grafting on the arrested heart is a prerequisite for successful totally endoscopic beating heart coronary revascularisation Interactive CardioVascular and Thoracic Surgery, September 1, 2002; 1(1): 30 - 34. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Dogan, T. Aybek, E. Andre{beta}en, C. Byhahn, S. Mierdl, K. Westphal, G. Matheis, A. Moritz, and G. Wimmer-Greinecker Totally endoscopic coronary artery bypass grafting on cardiopulmonary bypass with robotically enhanced telemanipulation: Report of forty-five cases J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1125 - 1131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bucerius, S. Metz, T. Walther, V. Falk, N. Doll, F. Noack, D. Holzhey, A. Diegeler, and F. W. Mohr Endoscopic internal thoracic artery dissection leads to significant reduction of pain after minimally invasive direct coronary artery bypass graft surgery Ann. Thorac. Surg., April 1, 2002; 73(4): 1180 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. W Susilo and A. P Schulz Totally Robotic Technique in Multivessel Coronary Disease -- Is it Possible? Asian Cardiovasc Thorac Ann, March 1, 2002; 10(1): 92 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ruel, R. B. Streeter, R. de la Torre, J. R. Liddicoat, and W. E. Cohn Intracardiac ultrasonic suture welding for knotless mitral valve replacement Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 245 - 248. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
