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J Thorac Cardiovasc Surg 1999;117:1212-1213
© 1999 Mosby, Inc.


BRIEF COMMUNICATIONS

COMPUTER-ENHANCED CORONARY ARTERY BYPASS SURGERY

Friedrich W. Mohr, MD, PhD, Volkmar Falk, MD, Anno Diegeler, MD, Rüdiger Autschback, MD, PhD, Leipzig, Germany

From the Department of Cardiac Surgery, Heartcenter, University of Leipzig, Germany.

Received for publication Sept 30, 1998. Accepted for publication Oct 30, 1998. Address for reprints: Friedrich W. Mohr, MD, PhD, Klinik für Herzchirurgie, Universität Leipzig, Herzzentrum, Russenstraße 19, 04289 Leipzig, Germany.

The development of closed chest cardiopulmonary bypass systems has potentially opened the door for totally endoscopic coronary artery bypass graft surgery. Because of the limited range of motion of conventional endoscopic instruments with only 4 degrees of freedom, complex surgical tasks like suturing an anastomosis are difficult and time consuming. Thoracoscopic techniques are currently limited to harvesting of the internal thoracic artery (ITA).Go Go 1,2 Computer-enhanced surgery has been developed to overcome the limitations of conventional endoscopic instruments.Go Go 3,4

Patients and methods

As opposed to off-line pre-programmed robotic systems, the endoscopic instrument control system (Intuitive Surgical, Mountain View, Calif) is a supervised on-line robotic system with 3 robotic arms of serial articulating joint architecture. The surgeon operates from a control console that provides a 3-dimensional thoracoscopic image and is in steady control of the system via a human-machine interface. Surgical tasks like suturing or cutting are performed by the surgeon acting on master manipulators at the console that remotely control the motions of surgical instruments (effectors) via a computer interface (Fig. 1).The surgical manipulators (2 designed to hold surgical tools and 1 designed to hold a 3-dimensional videoscope) that are mounted to a central column have 3 degrees of freedom (pitch, yaw, and insertion) and provide motion coupling for the end-effectors. These instruments add another 3 degrees of freedom by means of . . . [Full Text of this Article]




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