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Feasibility of bilateral internal thoracic artery harvesting using the da Vinci SP system

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Abstract

Purpose

We conducted this study to investigate the feasibility of mobilizing the bilateral internal thoracic arteries (ITAs) using the da Vinci SP through a single intercostal incision and to compare the amount of rib spreading with that required for mini-thoracotomy procedures. We also evaluated the construction of an intrathoracic T-graft anastomosis using existing instrumentation of the SP system.

Methods

We harvested bilateral ITAs from two male cadavers via a single incision made in the fifth intercostal space using the da Vinci SP. A T-graft end-to-side anastomosis was created in one cadaver.

Results

The bilateral ITAs were harvested in less than 60 min and a T-graft was completed. No additional rib spreading was required. Intraoperative adjustments of the da Vinci SP were necessary to maintain alignment with the surgical targets.

Conclusions

Bilateral ITA harvest using the da Vinci SP through a single intercostal incision was feasible, with less rib spreading than in mini-thoracotomy procedures. Thus, creating an intrathoracic T-graft with the existing da Vinci SP instruments is possible.

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Funding

Financial support and technology resources for the experimental study were provided by Intuitive Surgical Inc., Sunnyvale, CA, USA.

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Authors and Affiliations

  1. Department of Global Clinical Development, Intuitive Surgical Inc, 1020 Kifer Road, Sunnyvale, CA, 94086, USA

    Hubert Stein

  2. Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany

    Volkmar Falk

  3. Department of Cardiovascular Surgery, Charite, Berlin, Germany

    Volkmar Falk

  4. German Center of Cardiovascular Research, Partner Site, Berlin, Germany

    Volkmar Falk

  5. Department of Health Science and Technology, ETH Zurich, Zurich, Switzerland

    Volkmar Falk

Authors
  1. Hubert Stein
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  2. Volkmar Falk
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Correspondence to Hubert Stein.

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Conflict of interest

Volkmar Falk has no conflict of interest and no financial ties related to this study. Hubert Stein is an employee of Intuitive Surgical Inc. and owns stock equity in the company.

Freedom of investigation

The authors confirm that they had freedom of investigation and full control of the design of the study, methods used, outcome parameters and results, analysis of data, and production of the written report.

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Stein, H., Falk, V. Feasibility of bilateral internal thoracic artery harvesting using the da Vinci SP system. Surg Today 51, 303–308 (2021). https://doi.org/10.1007/s00595-020-02094-4

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  • DOI: https://doi.org/10.1007/s00595-020-02094-4

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