title: A highly articulated robotic surgical system for minimally invasive surgery.
abstract: OBJECTIVE
  We developed a novel, highly articulated robotic surgical system (CardioARM) to enable minimally invasive intrapericardial therapeutic delivery through a subxiphoid approach. We performed preliminary proof of concept studies in a porcine preparation by performing epicardial ablation.
  
  
  METHODS
  CardioARM is a robotic surgical system having an articulated design to provide unlimited but controllable flexibility. The CardioARM consists of serially connected, rigid cyclindrical links housing flexible working ports through which catheter-based tools for therapy and imaging can be advanced. The CardioARM is controlled by a computer-driven, user interface, which is operated outside the operative field.
  
  
  RESULTS
  In six experimental subjects, the CardioARM was introduced percutaneously through a subxiphoid access. A commercial 5-French radiofrequency ablation catheter was introduced through the working port, which was then used to guide deployment. In all subjects, regional ("linear") left atrial ablation was successfully achieved without complications.
  
  
  CONCLUSIONS
  Based on these preliminary studies, we believe that the CardioARM promises to enable deployment of a number of epicardium-based therapies. Improvements in imaging techniques will likely facilitate increasingly complex procedures.
authors.affiliation: Division of Cardiac Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Ota
authors.forename: Amir
authors.initials: A
authors.lastname: Degani
authors.forename: David
authors.initials: D
authors.lastname: Schwartzman
authors.forename: Brett
authors.initials: B
authors.lastname: Zubiate
authors.forename: Jeremy
authors.initials: J
authors.lastname: McGarvey
authors.forename: Howie
authors.initials: H
authors.lastname: Choset
authors.forename: Marco A
authors.initials: MA
authors.lastname: Zenati