HapticV1, PascalFrancis, Corpus, bibRecord, 000634

A laparoscopic knot-tying device for minimally invasive cardiac surgery

Identifieur interne : 000634 ( PascalFrancis/Corpus ); précédent : 000633; suivant : 000635

A laparoscopic knot-tying device for minimally invasive cardiac surgery

Auteurs : Shaphan R. Jernigan ; Guillaume Chanoit ; Arun Veeramani ; Stephen B. Owen ; Matthew Hilliard ; Denis Cormier ; Bryan Laffitte ; Gregory Buckner

Source :

European journal of cardio-thoracic surgery [ 1010-7940 ] ; 2010.

RBID : Pascal:10-0205172

Descripteurs français

Pascal (Inist)
- Laparoscopie, Dispositif, Chirurgie miniinvasive, Coeur, Fixation, Appareil circulatoire, Cardiologie, Pneumologie.

English descriptors

KwdEn :
- Cardiology, Circulatory system, Device, Fixation, Heart, Laparoscopy, Minimally invasive surgery, Pneumology.

Abstract

Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

A01	`01`	`1`		`@0 1010-7940`
A02	`01`			`@0 EJCSE7`
A03		`1`		`@0 Eur. j. cardio-thorac. surg.`
A05				`@2 37`
A06				`@2 3`
A08	`01`	`1`	`ENG`	`@1 A laparoscopic knot-tying device for minimally invasive cardiac surgery`
A11	`01`	`1`		`@1 JERNIGAN (Shaphan R.)`
A11	`02`	`1`		`@1 CHANOIT (Guillaume)`
A11	`03`	`1`		`@1 VEERAMANI (Arun)`
A11	`04`	`1`		`@1 OWEN (Stephen B.)`
A11	`05`	`1`		`@1 HILLIARD (Matthew)`
A11	`06`	`1`		`@1 CORMIER (Denis)`
A11	`07`	`1`		`@1 LAFFITTE (Bryan)`
A11	`08`	`1`		`@1 BUCKNER (Gregory)`
A14	`01`			`@1 Department of Mechanical and Aerospace Engineering, North Carolina State University @2 NC @3 USA @Z 1 aut. @Z 3 aut. @Z 4 aut. @Z 8 aut.`
A14	`02`			`@1 College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St @2 Raleigh, NC 27606 @3 USA @Z 2 aut.`
A14	`03`			`@1 Department of Industrial and Systems Engineering, North Carolina State University @2 NC @3 USA @Z 6 aut.`
A14	`04`			`@1 Department of Industrial Design, North Carolina State University @2 NC @3 USA @Z 5 aut. @Z 7 aut.`
A20				`@1 626-630`
A21				`@1 2010`
A23	`01`			`@0 ENG`
A43	`01`			`@1 INIST @2 21307 @5 354000180608640220`
A44				`@0 0000 @1 © 2010 INIST-CNRS. All rights reserved.`
A45				`@0 17 ref.`
A47	`01`	`1`		`@0 10-0205172`
A60				`@1 P`
A61				`@0 A`
A64	`01`	`1`		`@0 European journal of cardio-thoracic surgery`
A66	`01`			`@0 NLD`
C01	`01`		`ENG`	@0 Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.
C02	`01`	`X`		`@0 002B11`
C02	`02`	`X`		`@0 002B12`
C02	`03`	`X`		`@0 002B25E`
C02	`04`	`X`		`@0 002B24E06`
C03	`01`	`X`	`FRE`	`@0 Laparoscopie @5 09`
C03	`01`	`X`	`ENG`	`@0 Laparoscopy @5 09`
C03	`01`	`X`	`SPA`	`@0 Laparoscopia @5 09`
C03	`02`	`X`	`FRE`	`@0 Dispositif @5 10`
C03	`02`	`X`	`ENG`	`@0 Device @5 10`
C03	`02`	`X`	`SPA`	`@0 Dispositivo @5 10`
C03	`03`	`X`	`FRE`	`@0 Chirurgie miniinvasive @5 11`
C03	`03`	`X`	`ENG`	`@0 Minimally invasive surgery @5 11`
C03	`03`	`X`	`SPA`	`@0 Cirugía mini invasiva @5 11`
C03	`04`	`X`	`FRE`	`@0 Coeur @5 12`
C03	`04`	`X`	`ENG`	`@0 Heart @5 12`
C03	`04`	`X`	`SPA`	`@0 Corazón @5 12`
C03	`05`	`X`	`FRE`	`@0 Fixation @5 13`
C03	`05`	`X`	`ENG`	`@0 Fixation @5 13`
C03	`05`	`X`	`SPA`	`@0 Fijación @5 13`
C03	`06`	`X`	`FRE`	`@0 Appareil circulatoire @5 14`
C03	`06`	`X`	`ENG`	`@0 Circulatory system @5 14`
C03	`06`	`X`	`SPA`	`@0 Aparato circulatorio @5 14`
C03	`07`	`X`	`FRE`	`@0 Cardiologie @5 15`
C03	`07`	`X`	`ENG`	`@0 Cardiology @5 15`
C03	`07`	`X`	`SPA`	`@0 Cardiología @5 15`
C03	`08`	`X`	`FRE`	`@0 Pneumologie @5 16`
C03	`08`	`X`	`ENG`	`@0 Pneumology @5 16`
C03	`08`	`X`	`SPA`	`@0 Neumología @5 16`
C07	`01`	`X`	`FRE`	`@0 Endoscopie @5 37`
C07	`01`	`X`	`ENG`	`@0 Endoscopy @5 37`
C07	`01`	`X`	`SPA`	`@0 Endoscopía @5 37`
N21				`@1 137`
N44	`01`			`@1 OTO`
N82				`@1 OTO`

Format Inist (serveur)

NO :	PASCAL 10-0205172 INIST
ET :	A laparoscopic knot-tying device for minimally invasive cardiac surgery
AU :	JERNIGAN (Shaphan R.); CHANOIT (Guillaume); VEERAMANI (Arun); OWEN (Stephen B.); HILLIARD (Matthew); CORMIER (Denis); LAFFITTE (Bryan); BUCKNER (Gregory)
AF :	Department of Mechanical and Aerospace Engineering, North Carolina State University/NC/Etats-Unis (1 aut., 3 aut., 4 aut., 8 aut.); College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St/Raleigh, NC 27606/Etats-Unis (2 aut.); Department of Industrial and Systems Engineering, North Carolina State University/NC/Etats-Unis (6 aut.); Department of Industrial Design, North Carolina State University/NC/Etats-Unis (5 aut., 7 aut.)
DT :	Publication en série; Niveau analytique
SO :	European journal of cardio-thoracic surgery; ISSN 1010-7940; Coden EJCSE7; Pays-Bas; Da. 2010; Vol. 37; No. 3; Pp. 626-630; Bibl. 17 ref.
LA :	Anglais
EA :	Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.
CC :	002B11; 002B12; 002B25E; 002B24E06
FD :	Laparoscopie; Dispositif; Chirurgie miniinvasive; Coeur; Fixation; Appareil circulatoire; Cardiologie; Pneumologie
FG :	Endoscopie
ED :	Laparoscopy; Device; Minimally invasive surgery; Heart; Fixation; Circulatory system; Cardiology; Pneumology
EG :	Endoscopy
SD :	Laparoscopia; Dispositivo; Cirugía mini invasiva; Corazón; Fijación; Aparato circulatorio; Cardiología; Neumología
LO :	INIST-21307.354000180608640220
ID :	10-0205172

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Pascal:10-0205172

Le document en format XML

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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">A laparoscopic knot-tying device for minimally invasive cardiac surgery</title>
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<front><div type="abstract" xml:lang="en">Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.</div>
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<fA08 i1="01" i2="1" l="ENG"><s1>A laparoscopic knot-tying device for minimally invasive cardiac surgery</s1>
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<fA11 i1="01" i2="1"><s1>JERNIGAN (Shaphan R.)</s1>
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<fA11 i1="02" i2="1"><s1>CHANOIT (Guillaume)</s1>
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<fA11 i1="03" i2="1"><s1>VEERAMANI (Arun)</s1>
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<fA11 i1="04" i2="1"><s1>OWEN (Stephen B.)</s1>
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<fA11 i1="05" i2="1"><s1>HILLIARD (Matthew)</s1>
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<fA11 i1="06" i2="1"><s1>CORMIER (Denis)</s1>
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<fA11 i1="07" i2="1"><s1>LAFFITTE (Bryan)</s1>
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<fA11 i1="08" i2="1"><s1>BUCKNER (Gregory)</s1>
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<fA14 i1="01"><s1>Department of Mechanical and Aerospace Engineering, North Carolina State University</s1>
<s2>NC</s2>
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<fA14 i1="02"><s1>College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St</s1>
<s2>Raleigh, NC 27606</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
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<fA14 i1="03"><s1>Department of Industrial and Systems Engineering, North Carolina State University</s1>
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<fA14 i1="04"><s1>Department of Industrial Design, North Carolina State University</s1>
<s2>NC</s2>
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<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
</fA14>
<fA20><s1>626-630</s1>
</fA20>
<fA21><s1>2010</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>21307</s2>
<s5>354000180608640220</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2010 INIST-CNRS. All rights reserved.</s1>
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<fA45><s0>17 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>10-0205172</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>European journal of cardio-thoracic surgery</s0>
</fA64>
<fA66 i1="01"><s0>NLD</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B11</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B12</s0>
</fC02>
<fC02 i1="03" i2="X"><s0>002B25E</s0>
</fC02>
<fC02 i1="04" i2="X"><s0>002B24E06</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Laparoscopie</s0>
<s5>09</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Laparoscopy</s0>
<s5>09</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Laparoscopia</s0>
<s5>09</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Dispositif</s0>
<s5>10</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Device</s0>
<s5>10</s5>
</fC03>
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<s5>10</s5>
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<s5>11</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Minimally invasive surgery</s0>
<s5>11</s5>
</fC03>
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<s5>11</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Coeur</s0>
<s5>12</s5>
</fC03>
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<s5>12</s5>
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<s5>12</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Fixation</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Fixation</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Fijación</s0>
<s5>13</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Appareil circulatoire</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Circulatory system</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Aparato circulatorio</s0>
<s5>14</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Cardiologie</s0>
<s5>15</s5>
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<fC03 i1="07" i2="X" l="ENG"><s0>Cardiology</s0>
<s5>15</s5>
</fC03>
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<s5>15</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Pneumologie</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Pneumology</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Neumología</s0>
<s5>16</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Endoscopie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Endoscopy</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Endoscopía</s0>
<s5>37</s5>
</fC07>
<fN21><s1>137</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
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<server><NO>PASCAL 10-0205172 INIST</NO>
<ET>A laparoscopic knot-tying device for minimally invasive cardiac surgery</ET>
<AU>JERNIGAN (Shaphan R.); CHANOIT (Guillaume); VEERAMANI (Arun); OWEN (Stephen B.); HILLIARD (Matthew); CORMIER (Denis); LAFFITTE (Bryan); BUCKNER (Gregory)</AU>
<AF>Department of Mechanical and Aerospace Engineering, North Carolina State University/NC/Etats-Unis (1 aut., 3 aut., 4 aut., 8 aut.); College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St/Raleigh, NC 27606/Etats-Unis (2 aut.); Department of Industrial and Systems Engineering, North Carolina State University/NC/Etats-Unis (6 aut.); Department of Industrial Design, North Carolina State University/NC/Etats-Unis (5 aut., 7 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>European journal of cardio-thoracic surgery; ISSN 1010-7940; Coden EJCSE7; Pays-Bas; Da. 2010; Vol. 37; No. 3; Pp. 626-630; Bibl. 17 ref.</SO>
<LA>Anglais</LA>
<EA>Objective: Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator. Methods: To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament. Results: Mean knot-tying times were 246 ± 116 s and 102 ± 46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p = 0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1 N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p = 0.914, paired t-test). Conclusions: Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.</EA>
<CC>002B11; 002B12; 002B25E; 002B24E06</CC>
<FD>Laparoscopie; Dispositif; Chirurgie miniinvasive; Coeur; Fixation; Appareil circulatoire; Cardiologie; Pneumologie</FD>
<FG>Endoscopie</FG>
<ED>Laparoscopy; Device; Minimally invasive surgery; Heart; Fixation; Circulatory system; Cardiology; Pneumology</ED>
<EG>Endoscopy</EG>
<SD>Laparoscopia; Dispositivo; Cirugía mini invasiva; Corazón; Fijación; Aparato circulatorio; Cardiología; Neumología</SD>
<LO>INIST-21307.354000180608640220</LO>
<ID>10-0205172</ID>
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A laparoscopic knot-tying device for minimally invasive cardiac surgery

A laparoscopic knot-tying device for minimally invasive cardiac surgery

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