La chirurgie des coronaires assistée par ordinateur [Computer-assisted coronary surgery]

Details

Serval ID
serval:BIB_0546A29B099D
Type
Article: article from journal or magazin.
Collection
Publications
Title
La chirurgie des coronaires assistée par ordinateur [Computer-assisted coronary surgery]
Journal
Bulletin de l'Academie nationale de medecine
Author(s)
Loisance D., Houël R., Kirsch M., Rosanval O., Thebert D.
ISSN
0001-4079 (Print)
ISSN-L
0001-4079
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
185
Number
7
Pages
1225-36; discussion 1236-8
Language
french
Notes
Publication types: English Abstract ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Routine totally endoscopic, beating heart, coronary surgery should be made possible by the use of computer enhanced surgical techniques. It includes a totally endoscopic mammary artery harvesting, a correct exposure and an adequate stabilization of the coronary artery at the anastomotic site, a perfect anastomosis of the mammary artery on the left anterior descending coronary artery using a microsurgical suture technique. This complex surgical protocol will be reached by a step by step approach. The first 20 patients who accepted to be operated with tele-manipulated instruments make the substance of this first report. In 19 cases, the dissection of the internal mammary artery could be performed with an optimal result: the lack of bleeding during the dissection emphasizes the excellent visualization of the operative field and the precision of the dissection. The satisfactory blood flow in the mammary artery at the time of the coronary anastomosis suggests the lack of spasm and confirms the atraumatic dissection. The distal anastomosis of the coronary bypass has been performed through a mid line sternotomy to avoid an excessive prolongation of the operative time. The anatomic conditions and the quality of the vessel wall allowed to perform the coronary anastomosis with the tele-manipulated instruments in nine cases only: in six patients, the mammary artery has been implanted on the descending artery, in three, a venous autograft on the diagonal branch. Our initial clinical experience with this new technique suggests that a very precise and fine surgery can be performed with an acceptable prolongation of the operative time. More experience and further developments in the instrumentation are nevertheless required to allow completion of the entire procedure totally closed chest, on a beating heart.
Keywords
Aged, Anastomosis, Surgical, Coronary Artery Bypass/methods, Coronary Disease/surgery, Female, Humans, Male, Mammary Arteries/surgery, Middle Aged, Prospective Studies, Therapy, Computer-Assisted/methods, Treatment Outcome
Pubmed
Web of science
Create date
30/03/2019 16:58
Last modification date
20/08/2019 12:27
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