title: Robotic manipulators in cardiac surgery: the computer-assisted surgical system ZEUS.
abstract: Minimally invasive strategies continue to evolve in cardiac surgery. Robotic-assisted systems have been introduced recently, to increase the precision of endoscopic coronary surgery. This report describes the experimental and clinical use of the computer-assisted robotic system ZEUS for endoscopic coronary artery bypass anastomoses. The ZEUS system consists of three interactive robotic arms and a control unit, allowing the surgeon to move the instrument arms in a scaled-down mode. The third arm (AESOP) positions the endoscope under voice control. The present study demonstrates the feasibility of endoscopic coronary artery bypass grafting using a computer-assisted surgical robotic system on the arrested heart, as well as on the beating heart in selected patients. However, robotic-assisted cardiac surgery is still developing, and tremendous efforts are still required to establish a routine procedure.