Robotic computer-assisted telemanipulation enhances coronary artery bypass.

Abstract

Totally endoscopic coronary artery bypass grafting depends greatly on perfecting the anastomosis. We tested a new computer-assisted telemanipulation robot (Intuitive Surgical Inc, Mountain View, Calif) in performing endoscopic coronary bypass. On-bench anastomoses of the porcine arterial graft to the left anterior descending coronary artery were performed with both direct visualization and conventional surgical instruments (group I), endoscopic 3-dimensional visualization and current endoscopic surgical instruments (group II), direct visualization and endoscopic instruments (group III), 3-dimensional endoscopic visualization and conventional surgical instruments (group IV), and telemanipulation robotic with 3-dimensional endoscopic visualization (group V). Anastomoses (n = 6 in each group) were assessed for time (minutes), quality (good = 3, fair = 2, poor = 1), technical difficulty (easy-difficult: 1-4), and patency (100% = 1, >50% = 2, <50% = 3). Anastomotic time was significantly longer in groups II and III than in groups IV and V (P </=.02). Patency was comparable in all groups. Telemanipulation technology may enhance the performance of totally endoscopic coronary artery anastomosis. The facility and time of an Intuitive telemanipulation anastomosis is comparable with that of a conventional anastomosis created under direct vision.