Robotic-enhanced arterial revascularization for multivessel coronary artery disease

Background. A tendency to reduce operative trauma is determining the evolut ion of cardiac surgical techniques lately. The introduction of robotic-enha nced endoscopic systems enables surgeons to perform arterial revascularizat ion for multivessel disease without sternotomy. Methods. From May 1999, 17 (4 women, 13 men; median age 63 +/- 7.4 years) p atients with multivessel coronary artery disease were treated surgically us ing arterial revascularization by means of bilateral internal mammary arter ies. Both arteries were harvested endoscopically using the da Vinci system (Intuitive Surgical, Mountain View, CA). These vessels were anastomosed usi ng the "Dresden technique." Results. Survival was 100%. Mean duration of the operation was 255 +/- 40.4 minutes. Bilateral internal mammary artery harvesting took 88.5 +/- 15.9 m inutes; cross-clamp time was 36 +/- 8.7 minutes. An average of 2.06 anastom oses were performed per operation. Postoperatively, patients remained in th e intensive care unit for 21 +/- 13 hours. One patient (5.8%) needed reexpl oration due to bleeding. Conclusions. The robotic surgical system introduces a new treatment of coro nary artery disease to surgical practice, and enables arterial revasculariz ation with distinctly reduced surgical trauma. (Ann Thorac Surg 2000;70:106 0-2) (C) 2000 by The Society of Thoracic Surgeons.