Hybrid robotic coronary artery surgery and angioplasty in multivessel coronaryartery disease

Ståhl, Kenneth; Boyd, W. Douglas; Vassiliades, Thomas A.; Karamanoukian, Hratch L.

doi:10.1016/s0003-4975(02)03889-4

Cited by 70 publications

(37 citation statements)

References 20 publications

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“…The good results in the present series are to be noted in the case of complete revascularization in patients with multivessel coronary artery disease, compared to results reported for surgery or PCI alone [19,20,21]. Compared to other hybrid revascularization series involving right coronary stenting [22,23,24], our follow-up results were very satisfactory. We did not perform mini-sternotomy, as this precludes coronary reconstruction.…”

Section: Discussionsupporting

confidence: 61%

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Gilard¹,

Bezon

Cornily³

et al. 2007

Cardiology

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Section: Discussionsupporting

confidence: 61%

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Gilard¹,

Bezon

Cornily³

et al. 2007

Cardiology

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“…The next steps are to continue parameter tuning to further reduce execution time, extend the vision system to allow denser arrangements of tumor targets, develop analytic models of deformable tissue, and apply the LBO framework to other FLS subtasks, axillary dissection [18], and cardiothoracic vein harvesting [32].…”

Section: Discussionmentioning

confidence: 99%

Learning by observation for surgical subtasks: Multilateral cutting of 3D viscoelastic and 2D Orthotropic Tissue Phantoms

Murali

Sen

Kehoe

et al. 2015

2015 IEEE International Conference on Robotics and Automation (ICRA)

162

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Abstract-Automating repetitive surgical subtasks such as suturing, cutting and debridement can reduce surgeon fatigue and procedure times and facilitate supervised tele-surgery. Programming is difficult because human tissue is deformable and highly specular. Using the da Vinci Research Kit (DVRK) robotic surgical assistant, we explore a "Learning By Observation" (LBO) approach where we identify, segment, and parameterize sub-trajectories ("surgemes") and sensor conditions to build a finite state machine (FSM) for each subtask. The robot then executes the FSM repeatedly to tune parameters and if necessary update the FSM structure. We evaluate the approach on two surgical subtasks: debridement of 3D Viscoelastic Tissue Phantoms (3d-DVTP), in which small target fragments are removed from a 3D viscoelastic tissue phantom, and Pattern Cutting of 2D Orthotropic Tissue Phantoms (2d-PCOTP), a step in the standard Fundamentals of Laparoscopic Surgery training suite, in which a specified circular area must be cut from a sheet of orthotropic tissue phantom. We describe the approach and physical experiments, which yielded a success rate of 96% for 50 trials of the 3d-DVTP subtask and 70% for 20 trials of the 2d-PCOTP subtask.

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“…A multicenter series [ 191 ] and a small, single-center series [ 192 ] have shown that videoscopic mobilization of the LIMA and opening of the pericardium, using a voice-operated robotic arm to manipulate When minimally invasive direct coronary artery bypass was fi rst being used, surgeons harvested the left internal mammary artery through a small anterior thoracotomy by aggressively retracting the anterior chest wall. This technique caused a great deal of postoperative discomfort for the patient and was sometimes technically challenging for the surgeon Fig.…”

Section: Hybrid Minimally Invasive Direct Coronary Artery Bypass/endomentioning

confidence: 99%

Surgical Treatment of Coronary Artery Disease

Cohn

Frazier

Mallidi

et al. 2015

Cardiovascular Medicine

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Techniques and technology for treating coronary artery disease (CAD) have evolved significantly over the past 50 years. Although there are cases in which the best treatment approach (medical, surgical, or catheter-based) is clear, the best choice of intervention is not obvious for the majority of patients. Five, seven, and ten years after initial treatment, mortality is lower for coronary artery bypass grafting (CABG) than for medical treatment alone. The survival benefi ts of CABG are particularly substantial for patients with 3-vessel or left main artery disease, severe angina, or a positive pretreatment exercise stress test.Most trials that have compared CABG with percutaneous coronary intervention (PCI) in patients with multivessel disease have shown similar short-term survival benefi ts, but PCI has been associated with less periprocedural morbidity, including stroke, whereas CABG has been associated with longer-lasting revascularization.Technical innovations made in the attempt to reduce the negative impact of cardiopulmonary bypass (CPB) include reducing contact between blood and the CPB mechanism by coating the internal surface with heparin or other polymers, minimizing hemodilution by shrinking the bypass circuit to reduce the amount of crystalloid prime needed to start CPB, and using hemofi ltration to protect the heart and end organs. There is not yet complete agreement about the relative safety and effi cacy of off-pump coronary artery bypass (OPCAB) versus conventional CABG with CPB.Results of small randomized trials suggest that, in patients with stenosis of the proximal LAD, minimally invasive direct coronary artery bypass (MIDCAB) is associated with a longer in-hospital recovery period and higher costs than is direct stenting, but that MIDCAB produces similar or better short-and long-term outcomes. Totally endoscopic coronary artery bypass (TECAB) aided by computer-controlled surgical robotic devices has continued to slowly evolve over the last decade, and several centers have reported favorable results. The technical challenges and procedural costs have prevented the widespread application of this technology. • Techniques and technology for treating coronary artery disease (CAD) have evolved signifi cantly over the past 50 years.• Although there are cases in which the best treatment approach (medical, surgical, or catheterbased) is clear, the best choice of intervention is not obvious for the majority of patients.• Five, 7, and 10 years after initial treatment, mortality is lower for coronary artery bypass grafting (CABG) than for medical treatment alone. The survival benefi ts of CABG are particularly substantial for patients with 3-vessel or left main artery disease, severe angina, or a positive pretreatment exercise stress test.• Most trials that have compared CABG with percutaneous coronary intervention (PCI) in patients with multivessel disease have shown similar shortterm survival benefi ts, but PCI has been associated with less periprocedural morbidity, including stroke, whereas CA...

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Hybrid robotic coronary artery surgery and angioplasty in multivessel coronaryartery disease

Cited by 70 publications

References 20 publications

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Learning by observation for surgical subtasks: Multilateral cutting of 3D viscoelastic and 2D Orthotropic Tissue Phantoms

Surgical Treatment of Coronary Artery Disease

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