Cost and Outcome of Minimally Invasive Techniques for Coronary Surgery Using Robotic Technology

Objective Totally endoscopic coronary artery bypass (TECAB) with robotic distal anastomosis and robotic-assisted minimally invasive coronary artery bypass (RA-MIDCAB) with robotic internal mammary artery harvest and direct hand-sewn distal anastomosis via an anterior thoracotomy have both been reported as safe and efficacious. We compared hospital cost and short-term outcomes between these techniques. Methods Patients who underwent robotic-assisted minimally invasive single-vessel Coronary artery bypass grafting (2011–2014) were retrospectively reviewed. One hundred consecutive patients underwent either TECAB (n = 50) or RA-MIDCAB (n = 50). The two groups were sequential with TECAB performed by one surgeon in the first portion of the study interval and RA-MIDCAB by another surgeon in the latter. Demographics, short-term outcomes, and hospital cost data were compared between the two groups. Results Patient demographics and preoperative risk factors were similar between the TECAB and RA-MIDCAB groups, as total operating room time. Cardiopulmonary bypass was used for 56% of TECAB and 0% of RA-MIDCAB cases (P
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

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CONCLUSIONS: Endo-CABG can be considered a safe and effective procedure to treat single- and multi-vessel coronary artery disease. Individual patient selection seems not necessary to apply this technique. PMID: 31926795 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Publication date: January 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 1Author(s): Taichi Sakaguchi, Tomohiro Mizuno, Masaaki Ryomoto, Naosumi Sekiya, Toshinori Totsugawa, Kentaro Tamura, Arudo Hiraoka, Hirokuni AraiProper positioning of the heart through a small left thoracotomy is the main challenge during off-pump minimally invasive cardiac coronary artery bypass grafting. Here we report a novel technique for target vessel exposure using the Tentacles NEO (Sumitomo Bakelite, Co Ltd, Tokyo, Japan) multisuction heart positioner, a device with 3 independent small suction cups that can be applied to various...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Coronary artery bypass grafting represents one of the most commonly performed cardiac surgeries worldwide. Recently, interest has increased in providing patients with a less invasive approach to cardiac surgery, such as thoracotomy and endoscopic techniques using robotic technology as an alternative to traditional sternotomy. As the population gets older, the need for additional methods to provide care for sick patients will continue to expand. These advancements will further allow physicians to provide cardiac surgical procedures with less pain and faster recovery for patients.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
Purpose of review Coronary artery bypass grafting evolved in incremental but significant steps since its introduction. Here, we provide an update on operative techniques, choice of conduits, patient selection/decision-making and primary and secondary prevention measures with potential of influencing the future of coronary artery bypass grafting (CABG) surgery. Recent findings Associated mortality of off-pump CABG (OPCAB) procedures performed in high-volume OPCAB centers (≥164 cases per year) and by experienced surgeons (≥48 cases per year) was reduced compared with on-pump CABG with two or more grafts suggesting...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CORONARY ARTERY SURGERY: Edited by Marc Ruel Source Type: research
Publication date: Available online 10 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Taichi Sakaguchi, Tomohiro Mizuno, Masaaki Ryomoto, Naosumi Sekiya, Toshinori Totsugawa, Kentaro Tamura, Arudo Hiraoka, Hirokuni AraiAbstractProper positioning of the heart via a small left thoracotomy is the main challenge during off-pump minimally invasive coronary artery bypass grafting (MICS CABG). Here we report a novel technique for target vessel exposure using the Tentacles NEO multi-suction heart positioner, a device with three independent small suction cups that can be applied to various surfaces of the heart and p...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract Proper positioning of the heart via a small left thoracotomy is the main challenge during off-pump minimally invasive coronary artery bypass grafting (MICS CABG). Here we report a novel technique for target vessel exposure using the Tentacles NEO multi-suction heart positioner, a device with three independent small suction cups that can be applied to various surfaces of the heart and pulled toward any direction using attached traction chords. The armless design of the device enables the use of flexible exposure techniques and contributes to the safety and feasibility of MICS CABG. PMID: 31518590 [Pub...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
MINIMALLY invasive cardiac surgery (MICS) is being increasingly performed.1 Several approaches are listed under the term MICS, such as ministernotomy for aortic valve replacement, left minithoracotomy for minimally invasive direct coronary artery bypass, and right anterior minimally invasive thoracotomy (RMIT) principally for mitral or aortic valve surgery. Minimally invasive thoracotomy is associated with intense and prolonged postsurgical pain, which can be equal to that occurring after conventional sternotomy.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
ConclusionsEarly results of CABG with NT-SVGs were good. Some precautions must be taken during harvesting and anastomosis. Taking precautions described in this study may help reduce the risk of perioperative complications and make the no-touch technique the standard procedure for harvesting SVGs for CABG.
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Anti-fog solution packaged in a Tyvek peel pouch and it is placed into various kits. Kit are labeled as follows: ROBOTIC GENERAL, LAP CHOLE, GENERAL LAPAROSCOPY PACK-LF, T&A PACK, LAP CHOLE PACK-LF, LAPAROSCOPY PACK-LF, EAR ACCESSORY PACK, RF LAP CHOLEPACK (LCLUI)642-LF, GEN LAPAROSCOPY PACK-LF, LAPAROSCOPY PELVISCOPY PACK, LAP ABDOMINAL CDS-LF, GENERAL LAPAROSCOPY CDS, GYN LAPAROSCOPY CDS, CSMC/ENDOSINUS/NASAL PACK-LF, GENERAL LAPAROSCOPY PACK, GENERAL SURGERY, MODULE TONSIL, MODULE GYN LAP NATALIE, GEN SURGERY LAP CHOLE PACK, T &A CDS, GYN LAPAROSCOPY PACK, GENERAL LAPAROSCOPY, GYN LAPAROSCOPY, TONSIL PACK, LAPAROSCO...
Source: Medical Device Recalls - Category: Medical Devices Source Type: alerts
ConclusionBenefits of OPCABG include decreased bleeding and lower requirement of blood transfusions. This experience shows that OPCABG can be performed without systemic heparinization in selected cases.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
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