Totally Endoscopic Robotic Suturing Of A Coronary Bypass Anastomosis

Robotic technology has enabled totally endoscopic coronary bypass (TECAB) surgery for coronary artery disease. The surgical robot allows sewing of the graft to coronary artery anastomosis through tiny port holes without opening the chest at all. In this video Dr. Johannes Bonatti explains the surgical technique. He uses the da Vinci telemanipulator and controls the robotic instruments remotely from a console. The suture material is a double armed 7 cm 7/0 polypropylene thread. Sewing this anastomosis usually takes approximately 15 min on the arrested heart and 25 min on the beating heart. Before applying the surgical technique in patients surgeons are advised to perform 100 simulated anastomoses in wet-lab models. In the clinical setting the robotic surgeon sees the operative field in 3D and HD and is virtually immersed into the chest. Up to 10 fold magnification on the robotic camera and tremor filtration ensure highest levels of precision. Video by Johannes Bonatti, MD.