Computer-assisted telemanipulation: an enabling technology for endoscopic coronary artery bypass.
BACKGROUND
The ultimate objective of minimally invasive coronary artery bypass grafting is to perform the anastomosis totally endoscopically. In this feasibility study, we examined the potential of performing coronary artery bypass grafting with the use of computer-assisted telemanipulation technology.


METHODS
Intuitive Telemanipulation Technology (Intuitive Surgical, Mountain View, CA) was used to perform an arterial graft to left anterior descending coronary artery anastomosis in an ex vivo on-bench swine heart model. The degree of difficulty in performing the anastomosis, intraoperative events, duration of the anastomosis, and its quality were determined.


RESULTS
Anastomosis was performed with relative facility, in a range of 10.7 to 17.4 minutes (mean +/- standard deviation, 14.6 +/- 2.6 minutes). All anastomoses were patent and of good quality except one, which had 30% narrowing of its heel.


CONCLUSIONS
We conclude that Intuitive Telemanipulation Technology may in the future permit the performance of quality totally endoscopic coronary artery anastomosis with facility and acceptable time.
Department of Cardiothoracic Surgery, McGill University, Montreal, Quebec, Canada.
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Shennib
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Bastawisy
M J
MJ
Mack
F H
FH
Moll
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001026:Coronary Artery Bypass / Q000379:methods*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D012371:Robotics; D012815:Signal Processing, Computer-Assisted; D013552:Swine; D013813:Therapy, Computer-Assisted