title: Is there a role for robotic totally endoscopic coronary artery bypass in patients with a colostomy?
abstract: Preoperative colostomy presents a significant risk of sternal wound complications, mediastinitis, and ostomy injury in patients requiring coronary artery bypass grafting. Less invasive procedures in coronary surgery have a potential to reduce the risk of sternal wound healing problems. Robotic totally endoscopic coronary artery bypass grafting in patients with a colostomy has not been reported. We describe a case of completely endoscopic coronary surgery using the da Vinci Si system in a patient with a transverse colostomy. Single left internal mammary artery grafting to the left anterior coronary artery was performed successfully on the beating heart. We regard this technique as the least invasive method of surgical coronary revascularization with a potential to reduce the risk of surgical site infection and mediastinitis in patients with a colostomy.
authors.affiliation: From the *Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD USA; †Swedish Heart and Vascular Institute, Seattle, WA USA; and ‡Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH USA; and §Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Marc
authors.initials: M
authors.lastname: Gibber
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lehr
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Kon
authors.forename: P Brody
authors.initials: PB
authors.lastname: Wehman
authors.forename: Bartley P
authors.initials: BP
authors.lastname: Griffith
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonatti
mesh_terms: D002315:Cardiopulmonary Bypass; D003125:Colostomy; D001026:Coronary Artery Bypass / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000517:prevention & control; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control