Defining the learning curve for robotic-assisted endoscopic harvesting of the left internal mammary artery

Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery
Jonathan M HemliNirav C Patel

Abstract

Robotic-assisted techniques are continuing to cement their role in coronary surgery, particularly in facilitating the endoscopic harvesting of the left internal mammary artery (LIMA), regardless of how the subsequent bypass grafting is performed. As more surgeons attempt to become trained in robotic-assisted procedures, we sought to better define the learning curve associated with robotic-assisted endoscopic LIMA harvest. Between January 2011 and July 2012, a total of 77 patients underwent robotic-assisted minimally invasive direct coronary artery bypass surgery at our institution. The LIMA was harvested endoscopically in all patients, using standard robotic instruments, followed by direct grafting to anterior wall myocardial vessels via a small thoracotomy. Intraoperative times for various components of the procedure were collated and analyzed. The mean ± SD time taken to insert and position the ports for the robotic instruments was 3.9 ± 1.4 minutes. The mean ± SD LIMA harvest time was 31.8 ± 10.1 minutes, and the mean ± SD total robotic time was 44.2 ± 12.9 minutes. All time variables consistently continued to decrease as the experience of the operating surgeon increased, with the greatest magnitude of improvement being evid...Continue Reading

References

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Jan 1, 2013·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Jonathan M HemliNirav C Patel

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Citations

Sep 16, 2014·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Anna M BuehlerJefferson G Fernandes
Jun 28, 2015·The Annals of Thoracic Surgery·Shari L MeyersonThomas A D'Amico
Nov 9, 2018·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Hagen GorkiAndreas Liebold
Nov 27, 2018·Circulation·Mario GaudinoDavid P Taggart
Aug 31, 2021·Journal of Cardiac Surgery·William L PatrickMatthew L Williams

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