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Dr. Louis Brunsting on minimally invasive cardiothoracic surgery


Dr. Louis Brunsting
Cardiothoracic Surgery Associates, P.L.L.C.
Nashville, TN
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Dr. Brunsting speaks about the benefits of minimally invasive cardiac surgery for patients, Cardiologists and hospital administrators.

 

"At Columbia Presbyterian Hospital, we’ve performed nearly 100 cardiac surgery cases using the da Vinci® Surgical System. In quality of life surveys administered to patients undergoing cardiac procedures, those who had robotic procedures commented they had a faster recovery time, improved social functioning and returned to work faster than patients undergoing traditional surgery."

Michael Argenziano, M.D.
Assistant Professor of Surgery
Columbia University College of Physicians and Surgeons
New York Presbyterian Hospital
Physician Resources

da Vinci® Cardiac Revascularization


da Vinci Cardiac Revascularization (dVCR) is a radical modification of conventional coronary artery bypass surgery. It can be performed through a mini-thoracotomy rather than traditional sternotomy, without either cardiopulmonary bypass or cardioplegic arrest. Avoiding sternotomy and CPB provides an opportunity to provide the gold-standard treatment for coronary artery disease while reducing health-care resources and avoiding the documented risks and complications of sternotomy and CPB.

In Single-Vessel Small Thoracotomy (SVST) and Multi-Vessel Small Thoracotomy (MVST), the da Vinci Surgical System provides the precise instrumentation needed for the expeditious harvesting of the IMA from origin to bifurcation and the anastomosis of the LIMA to the LAD, all through a small, left-chest incision. With the use of a heart stabilization and exposure device, the procedure can be performed while the heart is still beating. LIMA-LAD anastomosis has a patency rate of 95% at 10 years and is the major factor in predicting long-term survival in patients with coronary artery disease.1

SVST and MVST are critical steps towards the performance of completely robotic – from IMA harvest to coronary anastomosis – cardiac revascularization. The precision, dexterity and superior visualization offered by the da Vinci System are essential to offering non-sternotomy benefits to patients undergoing coronary artery bypass surgery.

EndoWrist Instruments Optimized for dVCR

Micro-Bipolar Forceps

  • Finely serrated 6 mm jaws can expedite the IMA harvest
  • Jaw design is ideally suited for delicate tissue handling
  • Bipolar cautery facilitates side-branch ligation with minimal thermal dispersion

da Vinci MVST Benefit Summary

  • Uses da Vinci Bilateral IMA Harvest
  • Enables a mini-thoracotomy, multivessel procedure
  • Enables non-robotic multivessel grafting to anterior and lateral wall coronary arteries
  • Makes multivessel, off-pump procedures possible
  • Can help speed patient recovery
  • Promotes hybrid therapy
 

1. Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg. 2004 Jan;77(1):93-101. Abstract.