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J. Michael Smith1, Hubert Stein2, David Daunt2.
1Surgery, Good Samaritan Hospital, Cincinnati, OH, USA, 2Intuitive Surgical, Sunnyvale, CA, USA.
Objective
Demonstrate feasibility of performing beating heart CABG using a novel anastomotic device in conjunction with the daVinci S surgical robot.
Methods
Twelve adult swine underwent sternotomy and harvesting the LIMA. The da Vinci® S Robot was then used through the open sternotomy to manipulate the grafting device which was introduced through an intercostal port. This modified version of the Cardica C-Port® is activated from outside the chest cavity via a system of cables housed in a small diameter flexible “neck”. The IMA was robotically loaded onto the device. Using a specially designed stabilizer on the fourth arm of the robot, the LAD was stabilized and controlled proximally. An anastomosis was performed using the Cardica device. The device requires a small arteriotomy, which was closed separately with a single suture. The following were evaluated: ability to telemetrically create a successful anastomosis, hemostasis and acute patency of the anastomosis.
Results
All animals survived the procedure. All IMA’s were loaded without injury. Two devices failed to complete deployment. The successful deployments were completely patent. Average occlusion time was 3 minutes. Hemostasis was achieved without the need for additional sutures.
Conclusion
The Cardica device successfully demonstrated its ability to perform beating heart CABG when used in conjunction with the da Vinci® S Robot using a new stabilizer. This technology could truly open the way for reproducible less invasive CABG surgery.
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