Robotically enhanced coronary artery bypass surgery
Identifieur interne : 001999 ( Main/Exploration ); précédent : 001998; suivant : 001A00Robotically enhanced coronary artery bypass surgery
Auteurs : Yugal K. Mishra [Inde] ; H. Wasir [Inde] ; Malhotra Rajneesh [Inde] ; K. K. Sharma [Inde] ; Y. Mehta [Inde] ; N. Trehan [Inde]Source :
- Journal of Robotic Surgery [ 1863-2483 ] ; 2007.
Abstract
Robotically enhanced telemanipulation surgery is a rapidly developing technique which enables totally endoscopic cardiac surgery with utmost precision and perfection on both beating heart and arrested heart. Between December 2002 and September 2006, 268 patients underwent robotically enhanced coronary artery bypass surgery using the da Vinci telemanipulation system. Fourteen patients underwent total endoscopic coronary artery bypass surgery. Of these 12 were performed on a beating heart and 2 on an arrested heart. Two-hundred and fifty-four patients had endoscopic takedown of the internal mammary artery followed by minimally invasive direct coronary artery bypass in 193 patients and left anterolateral thoracotomy in 61 patients. The internal mammary artery mobilization time was 36 min (28–76 min) and the left internal mammary artery to left anterior descending artery anastomosis time ranged from 20 to 36 min for the totally endoscopic coronary artery bypass patients. The right internal mammary artery of one patient was anastomosed to diagonal artery totally endoscopically. The mean internal mammary artery flow by Doppler measurement in patients undergoing minimally invasive direct coronary artery bypass was 58 ml min−1. Seven patients required conversion to median sternotomy and coronary bypass surgery on the beating heart. The mean intensive care unit stay was 1.2 days and the mean hospital stay 4.5 days. There was one in-hospital mortality. All 14 patients who underwent total endoscopic bypass surgery had coronary angiography 3 months later which showed 100% patency in 13 patients. One patient had 50% anastomotic narrowing for which coronary angioplasty was performed in the same sitting. By using telematic technology, a complete endoscopic anastomosis is possible in both single vessels and suitable double vessel disease patients. The use of robotics is now extended to achieve complete myocardial revascularization by harvesting both the internal mammary arteries and making a small thoracotomy for direct anastomosis also.
Url:
DOI: 10.1007/s11701-007-0029-7
PubMed: 25484967
PubMed Central: 4247435
Affiliations:
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Mishra</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi, 110025 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Wasir, H" sort="Wasir, H" uniqKey="Wasir H" first="H." last="Wasir">H. Wasir</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi, 110025 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Rajneesh, Malhotra" sort="Rajneesh, Malhotra" uniqKey="Rajneesh M" first="Malhotra" last="Rajneesh">Malhotra Rajneesh</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi, 110025 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Sharma, K K" sort="Sharma, K K" uniqKey="Sharma K" first="K. 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Mehta</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Cardiovascular Anesthesiology, Escorts Heart Institute and Research Centre, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Cardiovascular Anesthesiology, Escorts Heart Institute and Research Centre, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Trehan, N" sort="Trehan, N" uniqKey="Trehan N" first="N." last="Trehan">N. Trehan</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi, 110025 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Robotic Surgery</title><idno type="ISSN">1863-2483</idno><idno type="eISSN">1863-2491</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Robotically enhanced telemanipulation surgery is a rapidly developing technique which enables totally endoscopic cardiac surgery with utmost precision and perfection on both beating heart and arrested heart. Between December 2002 and September 2006, 268 patients underwent robotically enhanced coronary artery bypass surgery using the da Vinci telemanipulation system. Fourteen patients underwent total endoscopic coronary artery bypass surgery. Of these 12 were performed on a beating heart and 2 on an arrested heart. Two-hundred and fifty-four patients had endoscopic takedown of the internal mammary artery followed by minimally invasive direct coronary artery bypass in 193 patients and left anterolateral thoracotomy in 61 patients. The internal mammary artery mobilization time was 36 min (28–76 min) and the left internal mammary artery to left anterior descending artery anastomosis time ranged from 20 to 36 min for the totally endoscopic coronary artery bypass patients. The right internal mammary artery of one patient was anastomosed to diagonal artery totally endoscopically. The mean internal mammary artery flow by Doppler measurement in patients undergoing minimally invasive direct coronary artery bypass was 58 ml min<sup>−1</sup>. Seven patients required conversion to median sternotomy and coronary bypass surgery on the beating heart. The mean intensive care unit stay was 1.2 days and the mean hospital stay 4.5 days. There was one in-hospital mortality. All 14 patients who underwent total endoscopic bypass surgery had coronary angiography 3 months later which showed 100% patency in 13 patients. One patient had 50% anastomotic narrowing for which coronary angioplasty was performed in the same sitting. By using telematic technology, a complete endoscopic anastomosis is possible in both single vessels and suitable double vessel disease patients. The use of robotics is now extended to achieve complete myocardial revascularization by harvesting both the internal mammary arteries and making a small thoracotomy for direct anastomosis also.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Talwalkar, Ng" uniqKey="Talwalkar N">NG Talwalkar</name></author><author><name sortKey="Cooley, Da" uniqKey="Cooley D">DA Cooley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Diegeler, A" uniqKey="Diegeler A">A Diegeler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Groh, M" uniqKey="Groh M">M Groh</name></author><author><name sortKey="Grossi, Ea" uniqKey="Grossi E">EA Grossi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wimmer Greinecker, G" uniqKey="Wimmer Greinecker G">G Wimmer-Greinecker</name></author><author><name sortKey="Matheis, G" uniqKey="Matheis G">G Matheis</name></author><author><name sortKey="Dogan, S" uniqKey="Dogan S">S Dogan</name></author><author><name sortKey="Aybek, T" uniqKey="Aybek T">T Aybek</name></author><author><name sortKey="Mierdl, S" uniqKey="Mierdl S">S Mierdl</name></author><author><name sortKey="Kessler, P" uniqKey="Kessler P">P Kessler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wimmer Greinecker, G" uniqKey="Wimmer Greinecker G">G Wimmer-Greinecker</name></author><author><name sortKey="Matheis, G" uniqKey="Matheis G">G Matheis</name></author><author><name sortKey="Dogan, S" uniqKey="Dogan S">S Dogan</name></author><author><name sortKey="Aybek, T" uniqKey="Aybek T">T Aybek</name></author><author><name sortKey="Kessler, P" uniqKey="Kessler P">P Kessler</name></author><author><name sortKey="Westphal, K" uniqKey="Westphal K">K Westphal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dogan, S" uniqKey="Dogan S">S 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sortKey="Kuntz, Re" uniqKey="Kuntz R">RE Kuntz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falk, V" uniqKey="Falk V">V Falk</name></author><author><name sortKey="Diegeler, A" uniqKey="Diegeler A">A Diegeler</name></author><author><name sortKey="Walther, T" uniqKey="Walther T">T Walther</name></author><author><name sortKey="Loscher, N" uniqKey="Loscher N">N Loscher</name></author><author><name sortKey="Vogel, B" uniqKey="Vogel B">B Vogel</name></author><author><name sortKey="Ulmann, C" uniqKey="Ulmann C">C Ulmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falk, V" uniqKey="Falk V">V Falk</name></author><author><name sortKey="Gummert, Jf" uniqKey="Gummert J">JF Gummert</name></author><author><name sortKey="Walther, T" uniqKey="Walther T">T Walther</name></author><author><name sortKey="Hayase, M" uniqKey="Hayase M">M Hayase</name></author><author><name sortKey="Berry, Gj" uniqKey="Berry G">GJ Berry</name></author><author><name sortKey="Mohr, Fw" uniqKey="Mohr F">FW Mohr</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Mishra, Yugal K" sort="Mishra, Yugal K" uniqKey="Mishra Y" first="Yugal K." last="Mishra">Yugal K. Mishra</name></noRegion><name sortKey="Mehta, Y" sort="Mehta, Y" uniqKey="Mehta Y" first="Y." last="Mehta">Y. Mehta</name><name sortKey="Rajneesh, Malhotra" sort="Rajneesh, Malhotra" uniqKey="Rajneesh M" first="Malhotra" last="Rajneesh">Malhotra Rajneesh</name><name sortKey="Sharma, K K" sort="Sharma, K K" uniqKey="Sharma K" first="K. K." last="Sharma">K. K. Sharma</name><name sortKey="Trehan, N" sort="Trehan, N" uniqKey="Trehan N" first="N." last="Trehan">N. Trehan</name><name sortKey="Wasir, H" sort="Wasir, H" uniqKey="Wasir H" first="H." last="Wasir">H. Wasir</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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