How To Improve Performance Of Robotic Totally Endoscopic Coronary Artery Bypass Grafting

Bonatti, Johannes; Schachner, Thomas; Bonaros, Nikolaos; Oehlinger, Armin; Ruetzler, Elisabeth; Jonetzko, Patrycja; Friedrich, Guy; Kreaden, Usha; Feuchtner, Gudrun; Pachinger, Otmar; Laufer, Guenther

doi:10.1097/01243895-200600140-00061

Cited by 15 publications

(23 citation statements)

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“…Among robotic approaches, Bonatti et al 17 and Schachner et al 25 reported on 85 patients who underwent totally endoscopic coronary artery bypass with the daVinci telemanipulation system between 2001 and 2006. The mean CPB time was 114 minutes, and the aortic endo-occlusion time was 65 minutes.…”

Section: Mics Cabg Versus Other Multivessel Minimally Invasive Technimentioning

confidence: 99%

Minimally Invasive Coronary Artery Bypass Grafting

et al. 2009

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Background-Minimally invasive coronary artery bypass grafting (MICS CABG) is a novel coronary operation that does not require infrastructure and is potentially available to all cardiac surgeons. It aims at decreasing the invasiveness of conventional CABG while preserving the applicability and durability of surgical revascularization. We examined the feasibility and safety of MICS CABG in the first large series of this operation to date. Methods and Results-All myocardial territories are accessed via a 4-to 6-cm left fifth intercostal thoracotomy. An apical positioner and epicardial stabilizer are introduced into the chest through the subxyphoid and left seventh intercostal spaces, respectively. The left internal thoracic artery is used to graft the left anterior descending artery, and radial artery or saphenous vein segments are used to graft the lateral and inferior myocardial territories. Proximal anastomoses are performed directly onto the aorta or from the left internal thoracic artery as a T-graft. In the first 450 consecutive MICS CABG procedures at our 2 centers, meanϮSD age was 62.3Ϯ10.7 years and 123 patients were female (27%). The average number of grafts was 2.1Ϯ0.7, with complete revascularization in 95% of patients. There were 34 patients in whom cardiopulmonary bypass was used (7.6%), 17 conversions to sternotomy (3.8%), and 10 reinterventions for bleeding (2.2%). Perioperative mortality occurred in 6 patients (1.3%). Conclusions-MICS CABG is feasible and has excellent procedural and short-term outcomes. This operation could potentially make multivessel minimally invasive coronary surgery safe, effective, and more widely available.

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Section: Mics Cabg Versus Other Multivessel Minimally Invasive Technimentioning

confidence: 99%

Minimally Invasive Coronary Artery Bypass Grafting

et al. 2009

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“…Another possible strategy is the use of minimally invasive or totally endoscopic procedures [46,47] . These procedures are associated with a number of advantages, e.g.…”

Section: Discussionmentioning

confidence: 99%

The Elderly Patient and Cardiac Surgery – A Mini-Review

Wiedemann

Bernhard²,

Laufer³

et al. 2009

Gerontology

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Introduction: Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care mean that more elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery and surgery of the ascending aorta are performed in elderly patients. Objective: In this review, we summarize the outcome of elderly patients undergoing various cardiac surgical procedures and give future perspectives for the treatment of elderly patients with cardiac surgery. Methods: A PubMed search for the period from 1980 to February 2009 was conducted with the following key words: ‘elderly patient’, ‘cardiac surgery’, ‘CABG aortic surgery’, ‘mitral valve surgery’ and ‘endocarditis’. Additional information concerning population demographics was obtained from the World Health Organization homepage. Results: More and more cardiac surgical procedures are offered to elderly patients. The short- and long-term survival rates of elderly patients are comparable to those of younger patients. Nevertheless, the risk for these patients is only acceptable in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease and a poor clinical state are associated with a worse outcome in elderly patients. Conclusion: The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia and myoacardial protection are basic requirements for the success of cardiac surgery in elderly patients.

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“…Neben Indikationen in der Herzthoraxchirurgie (Bypassoperationen, Lobektomien, Mitralklappeneingriff etc. [3,4,5]) werden von Seiten der Abdominalchirurgen Darmresektionen, Pankreatektomie, Y-Roux-Bypassoperationen und andere vorgestellt [6,7,8]. Mit einer deutlich höheren Frequenz erfolgen Eingriffe in der HNO (Thyroidektomie, Nasopharynxtumore; [9]) und der Gynäkolo-gie (Hysterektomien, Wertheim-MeiggsOperationen, Sakrokolpexien etc.…”

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Robotische Medizin in Deutschland: quo vadis?

Siemer

Stöckle

2011

Urologe

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Today, one can hardly imagine the medical daily routine without computer-assisted systems, although their benefit usually is not investigated by prospective randomised trials. While in the industrial working environment computer-assisted systems are thoroughly accepted because of their precision and endurance, in medicine there are fierce debates about their use at considerably high costs. At least the perioperative advantages (e.g. less blood loss, shorter period of hospitalization), to a large extent, are beyond dispute. The high costs may be compensated by a higher volume of treated patients. Only the treatment of a higher volume of patients will lead to a reduction of infrastructure costs per case. On the other hand, only a large number of cases ensure the achievement of skills to handle such a complex system. This, in return, reduces the chance of the occurrence of complications and shorter operation times will lead to economic advantages.

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How To Improve Performance Of Robotic Totally Endoscopic Coronary Artery Bypass Grafting

Cited by 15 publications

References 0 publications

Minimally Invasive Coronary Artery Bypass Grafting

Minimally Invasive Coronary Artery Bypass Grafting

The Elderly Patient and Cardiac Surgery – A Mini-Review

Robotische Medizin in Deutschland: quo vadis?

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