Shennib H, Bastawisy A, Mack M J, Moll F H
Department of Cardiothoracic Surgery, McGill University, Montreal, Quebec, Canada.
Ann Thorac Surg. 1998 Sep;66(3):1060-3. doi: 10.1016/s0003-4975(98)00659-6.
The ultimate objective of minimally invasive coronary artery bypass grafting is to perform the anastomosis totally endoscopically. In this feasibility study, we examined the potential of performing coronary artery bypass grafting with the use of computer-assisted telemanipulation technology.
Intuitive Telemanipulation Technology (Intuitive Surgical, Mountain View, CA) was used to perform an arterial graft to left anterior descending coronary artery anastomosis in an ex vivo on-bench swine heart model. The degree of difficulty in performing the anastomosis, intraoperative events, duration of the anastomosis, and its quality were determined.
Anastomosis was performed with relative facility, in a range of 10.7 to 17.4 minutes (mean +/- standard deviation, 14.6 +/- 2.6 minutes). All anastomoses were patent and of good quality except one, which had 30% narrowing of its heel.
We conclude that Intuitive Telemanipulation Technology may in the future permit the performance of quality totally endoscopic coronary artery anastomosis with facility and acceptable time.
微创冠状动脉旁路移植术的最终目标是完全通过内镜进行吻合。在这项可行性研究中，我们研究了使用计算机辅助远程操作技术进行冠状动脉旁路移植术的潜力。
使用直观远程操作技术（直观外科公司，加利福尼亚州山景城）在离体猪心脏模型上进行左前降支冠状动脉的动脉移植吻合。确定吻合的难度程度、术中事件、吻合持续时间及其质量。
吻合操作相对容易，时间在10.7至17.4分钟之间（平均±标准差，14.6±2.6分钟）。除一例吻合口足跟部有30%狭窄外，所有吻合口均通畅且质量良好。
我们得出结论，直观远程操作技术未来可能允许以简便且可接受的时间进行高质量的完全内镜冠状动脉吻合。
