title: Early experience with robotically assisted internal thoracic artery harvest.
abstract: We sought to determine the efficacy of using robotic assistance to facilitate endoscopic harvesting of internal thoracic arteries (ITAs). A total of 104 patients had ITAs harvested endoscopically with use of both the AESOP 3000 system (Computer Motion, Goleta, CA, U.S.A.) and Zeus robotic telesurgical system (Computer Motion). All ITAs were harvested with a harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH, U.S.A.). With the left lung collapsed, ITAs were harvested with CO2 insufflation through three 5-mm ports in the left chest. All patients tolerated insufflation without hemodynamic compromise. Average ITA harvest time was 61.3 +/- 20.9 minutes. Intraoperative graft flows averaged 36.3 +/- 22.4 mL/min. There were three distal ITA injuries; all other vessels were patent after harvesting and demonstrated no angiographic evidence of injury. This article demonstrates a technique by which ITA can be safely harvested totally endoscopically with use of computer-enhanced robotic systems and a harmonic scalpel, allowing complete pedicle dissection through 5-mm ports with minimal ITA manipulation.
authors: London Health Sciences Center, Ontario, Canada. boyd@robosurgeon.com
authors: W Douglas
authors: WD
authors: Boyd
authors: Bob
authors: B
authors: Kiaii
authors: Kojiro
authors: K
authors: Kodera
authors: Reiza
authors: R
authors: Rayman
authors: Walid
authors: W
authors: Abu-Khudair
authors: Shafie
authors: S
authors: Fazel
authors: Wojciech B
authors: WB
authors: Dobkowski
authors: Sugantha
authors: S
authors: Ganapathy
authors: George
authors: G
authors: Jablonsky
authors: Richard J
authors: RJ
authors: Novick
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D013895:Thoracic Arteries / Q000601:surgery* / Q000637:transplantation; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*