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J Thorac Cardiovasc Surg 1999;117:310-313
© 1999 Mosby, Inc.
SURGERY FOR ADULT CARDIOVASCULAR DISEASE |
From the Department of Cardiothoracic Surgery, McGill University, Montreal, Quebec, Canada.
Received for publication May 1, 1998. Revisions requested May 22, 1998; revisions received July 3, 1998. Accepted for publication Oct 1, 1998. Address for reprints: Hani Shennib, MD, The Montreal General Hospital, 1650 Cedar Ave, Suite L9-121, Montreal, Quebec H3G 1A4, Canada.
Objectives: Totally endoscopic coronary artery bypass grafting depends greatly on perfecting the anastomosis. We tested a new computer-assisted telemanipulation robot (Intuitive Surgical Inc, Mountain View, Calif) in performing endoscopic coronary bypass.
Methods: On-bench anastomoses of the porcine arterial graft to the left anterior descending coronary artery were performed with both direct visualization and conventional surgical instruments (group I), endoscopic 3-dimensional visualization and current endoscopic surgical instruments (group II), direct visualization and endoscopic instruments (group III), 3-dimensional endoscopic visualization and conventional surgical instruments (group IV), and telemanipulation robotic with 3-dimensional endoscopic visualization (group V). Anastomoses (n = 6 in each group) were assessed for time (minutes), quality (good = 3, fair = 2, poor = 1), technical difficulty (easy-difficult: 1-4), and patency (100% = 1, >50% = 2, <50% = 3).
Results: Anastomotic time was significantly longer in groups II and III than in groups IV and V (P 
.02). Patency was comparable in all groups.
Conclusion: Telemanipulation technology may enhance the performance of totally endoscopic coronary artery anastomosis. The facility and time of an Intuitive telemanipulation anastomosis is comparable with that of a conventional anastomosis created under direct vision.
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