title: Robotic surgery using Zeus MicroWrist technology: the next generation.
abstract: BACKGROUND
  The use of computer-animated surgical instruments for various cardiac operations has been shown to be feasible, but to date, the available information regarding the operative and technical details of these procedures is still inadequate.
  
  
  METHODS
  We used the Zeus (Computer Motion Inc., Goleta, Calif, USA) telemanipulation system to perform the internal mammary artery (IMA) takedown in 56 patients, in 12 of whom we used the newest model with MicroWristTM (Computer Motion Inc., Goleta, Calif, USA) technology. Port orientation was based on thoracic anatomy, the decisive landmarks being the mammillary line and the axillary line. The distance between ports was at least 9 cm, and the patient's arm was positioned with the left shoulder raised and angulated by not more than 90 degrees.
  
  
  RESULTS
  Mean setup time was 44 +/- 18 minutes for the first five patients and 16 +/- 7 minutes for the last five patients, with an overall average of 24 +/- 12 minutes. IMA harvest time at the beginning reached a mean of 95 +/- 23 minutes and decreased to 44 +/- 18 minutes in the last five cases. Average IMA takedown time was 58 +/- 17 minutes. The IMA was patent with a good flow in all 56 patients.
  
  
  CONCLUSIONS
  The introduction of robotic technology into clinical routine has resulted in safe procedures with a short learning curve. However, basic training in the modality is a must in order to achieve technical excellence.
authors.affiliation: Clinic for Cardiac Surgery, Heartcenter, Ludwigshafen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Isgro
authors.forename: Arndt-Holger
authors.initials: AH
authors.lastname: Kiessling
authors.forename: Markus
authors.initials: M
authors.lastname: Blome
authors.forename: Andreas
authors.initials: A
authors.lastname: Lehmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kumle
authors.forename: Werner
authors.initials: W
authors.lastname: Saggau
mesh_terms: D006348:Cardiac Surgical Procedures; D006801:Humans; D008323:Mammary Arteries / Q000601:surgery*; D008875:Middle Aged; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D025321:Surgery, Computer-Assisted