HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Volkmar Falk Anno Diegeler Thomas Walther Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Falk, V. Articles by Mohr, F. W. Search for Related Content PubMed PubMed Citation Articles by Falk, V. Articles by Mohr, F. W.

Ann Thorac Surg 1999;68:1555-1557
© 1999 The Society of Thoracic Surgeons

---

Supplement: Minimally Invasive Cardiac Surgery

Transabdominal endoscopic computer-enhanced coronary artery bypass grafting

^a Intuitive Surgical Inc, Mountain View, CA, USA
^b Heart Center, University of Leipzig, Leipzig, Germany

Presented at Evolving Techniques and Technologies in Minimally Invasive Cardiac Surgery, San Antonio, TX, Jan 22–23, 1999.

Abstract

Background. Due to limited range of motion, endoscopic multivessel revascularization is difficult through a thoracic approach.

Methods. A computer-enhanced surgical telemanipulation system was used to perform transabdominal endoscopic grafting (TCAB) in an experimental cadaver model. After incising the membranous portion of the diaphragm, pericardium, and pleura, dissection of the left (n = 10) and right internal thoracic arteries (n = 5) was performed. Coronary anastomoses were performed remotely and unassisted. In an animal model the hemodynamic consequences of the approach were assessed.

Results. In all cadavers TCAB was achieved through three abdominal ports. Time for internal thoracic arteries harvest was 48 ± 13 minutes (left) and 39 ± 10 minutes (right). Intimal dissection was found in one graft. Time for anastomosis was 23 ± 9 minutes and 27 ± 10 minutes for the left anterior descending (n = 10) and right coronary artery (n = 5), respectively. All anastomoses were patent. Opening the diaphragm in living animals led to a decrease of systolic blood pressure by 30 ± 16 mm Hg, but resolved with appropriate treatment.

Conclusions. TCAB is possible in cadavers using computer-enhanced telemanipulation technology. The transabdominal approach is a promising access for less invasive cardiac surgery.

This article has been cited by other articles:

				V. Falk Editorial comment: Why do it the easy way? Eur J Cardiothorac Surg, May 1, 2011; 39(5): 641 - 642. [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]

				F. W. Mohr, V. Falk, A. Diegeler, T. Walther, J. F. Gummert, J. Bucerius, S. Jacobs, and R. Autschbach Computer-enhanced ""robotic"" cardiac surgery: Experience in 148 patients J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 842 - 853. [Abstract] [Full Text] [PDF]

				C. Byhahn, S. Mierdl, D. Meininger, G. Wimmer-Greinecker, G. Matheis, and K. Westphal Hemodynamics and gas exchange during carbon dioxide insufflation for totally endoscopic coronary artery bypass grafting Ann. Thorac. Surg., May 1, 2001; 71(5): 1496 - 1501. [Abstract] [Full Text] [PDF]

				V. Falk, A. Diegeler, T. Walther, J. Banusch, J. Brucerius, J. Raumans, R. Autschbach, and F. W. Mohr Total endoscopic computer enhanced coronary artery bypass grafting Eur J Cardiothorac Surg, January 1, 2000; 17(1): 38 - 45. [Abstract] [Full Text] [PDF]