Abstract
Robotic coronary artery surgery has progressed with the advancements of robotic surgical system and the passion of advanced surgeons over the last two decades. Technologies of robotic-assisted surgery have been developed to overcome the limitations of the conventional endoscopic surgery. A surgical robot available for cardiac surgery is only the da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, CA, USA) in the world.
The patient’s setting of standard totally endoscopic coronary artery bypass graft (TECAB) including a left internal mammary artery (LIMA) to left anterior descending artery (LAD) is as follows: (1) general anesthesia with double-lumen tube intubation for single-lung ventilation, (2) supine position with the left chest slightly elevated, and (3) three ports placed in the third, fifth, and seventh intercostal spaces to 1 cm medial on the anterior axillary line. After a surgical cart is docked to an endoscopic camera and the instrument ports, an operation is performed by order of LIMA harvesting, identification of LAD after opening of a pericardium, stabilization of a target vessel, and anastomosis of LIMA to LAD.
Short-term outcomes of TECAB with either beating or arrested heart were acceptable; however, mid- to long-term outcomes were reported in few studies. Patient selection is very important to perform TECAB with the reduction of operative risk and complications.
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Tomita, S., Watanabe, G. (2016). Robotic Surgery. In: Asai, T., Ochi, M., Yokoyama, H. (eds) Off-Pump Coronary Artery Bypass. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54986-4_28
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DOI: https://doi.org/10.1007/978-4-431-54986-4_28
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