title: Robotic coronary artery surgery--the evolution of a new minimally invasive approach in coronary artery surgery.
abstract: BACKGROUND
  With the introduction of a wrist-enhanced robotic surgical system into minimally invasive cardiac surgery, the outlook of performing closed chest coronary artery bypass operations became a reality.
  
  
  METHODS
  Since May, 1999, this new wrist-enhanced instrumentation has been used in 109 (79 male, 30 female, median age 63 +/- 9.9 years) patients. Seven suffering from single vessel coronary artery disease (SVD) and double vessel disease (DVD) were treated as totally endoscopic coronary artery bypass (TECAB). 60 with SVD underwent a wrist-enhanced, minimally invasive direct coronary artery bypass procedure. 25 with DVD were treated using the robotically enhanced Dresden Technique coronary artery bypass.
  
  
  RESULTS
  Survival was 100%. In all patients the IMAs were safely harvested totally endoscopically. In the TECAB group, all patients were operated via a three-point stab incision. Data were observed during and after the operation.
  
  
  CONCLUSIONS
  Our preliminary experiences with this new surgical technique for the robotically enhanced, minimally invasive treatment of coronary artery disease promote an optimistic way of thinking about the further development of these procedures.
authors.affiliation: Cardiovascular Institute, University of Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Kappert
authors.forename: R
authors.initials: R
authors.lastname: Cichon
authors.forename: J
authors.initials: J
authors.lastname: Schneider
authors.forename: V
authors.initials: V
authors.lastname: Gulielmos
authors.forename: S M
authors.initials: SM
authors.lastname: Tugtekin
authors.forename: K
authors.initials: K
authors.lastname: Matschke
authors.forename: I
authors.initials: I
authors.lastname: Schramm
authors.forename: S
authors.initials: S
authors.lastname: Schueler
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000145:classification / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012371:Robotics / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D012720:Severity of Illness Index; D016019:Survival Analysis; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome