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J Thorac Cardiovasc Surg 2002;123:1029-1030
© 2002 The American Association for Thoracic Surgery

Editorials

Where are we going with computer-assisted or robotic cardiac surgery? A piece of the totally endoscopic coronary bypass puzzle

From Ohio State University, Columbus, Ohio.

Received for publication Feb 21, 2002. Accepted for publication March 20, 2002. Address for reprints: Randall K. Wolf, MD, Ohio State University, 410 West 10th Ave, n816 Doan Hall, Columbus, OH 43210.

	Introduction

 

View larger version (120K): [in this window] [in a new window]   Dr. Wolf

I don't skate to where the puck is; I skate to where the puck is going.

—Wayne GretzkySeveral years ago, a few cardiac surgeons who also performed general thorascopic surgery dreamed about a totally endoscopic coronary artery bypass grafting (CABG) technique. The concept of a totally endoscopic CABG technique (or e-CABG) was based on thorascopic principles. This became a challenge and goal for some researchers and for some in the medical industry.

The proposed advantage to e-CABG was no different from the advantage of general thoracoscopy over open techniques—to decrease the trauma of the operation and therefore decrease the morbidity related to conventional transthoracic access of the heart and aorta. It was postulated that endoscopic beating heart and left internal thoracic artery (LITA) to left anterior descending (LAD) coronary artery bypass could provide a durable, truly minimally invasive bypass procedure that would likely be superior in the long term to current interventional approaches to the diseased LAD.

Experimentation and clinical experience with modifications of general thorascopic techniques proved that the LITA could routinely be mobilized thoracoscopically, but that standard thorascopic instruments were inadequate for any usual or customary anastomotic technique. ^1-3 It became clear that the . . . [Full Text of this Article]

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