ROBOTIC SURGICAL-INSTRUMENTS FOR DEXTERITY ENHANCEMENT IN THORACOSCOPIC CORONARY-ARTERY BYPASS GRAFT

Objectives: Endoscopically sutured vascular anastomoses are complex, t ime consuming, and require great dexterity. We decided to evaluate per formance enhancement using a robotic device to create sutured coronary artery bypass anastomoses with endoscopic techniques in a plastic mod el. Methods: Seven coronary artery bypass anastomoses were endoscopica lly created in a plastic model using a robotic enhancement technology (Computer Motion, Goleta, CA). Anastomoses were created with a single running suture (7-0 monofilament). Our endpoints were operative time, intraoperative incidents, stability and dexterity of the robotic syste m, surgeon's fatigue, and anastomotic patency. Results: Operative time was 46 +/- 12 min (mean +/- SD). There were no intraoperative inciden ts. Patency was confirmed in all anastomoses. The system's stability a nd dexterity were high. Surgeon's fatigue was mild. Conclusion: The us e of robotic enhancement technology leads to an efficient performance of sutured coronary artery bypass anastomoses in a plastic model. The robotic device enhances dexterity, precision, and reduces surgeon's fa tigue while preserving the quality of hand suturing.