Robotically Enhanced “Dresden Technique” with Bilateral Internal Mammary Artery Grafting*

BACKGROUND: A tendency to reduce the operative trauma seems to be the prominent sign of development in cardiac surgery. The combination of the previously introduced minimally invasive "Dresden Technique" with the robotically enhanced endoscopic system enables further progress in coronary artery surgery. METHODS: From May 1999, 25 patients (19 male, 6 female, mean age 63 +/- 8.0 years) suffering from multivessel coronary artery disease (CAD) were treated surgically using arterial revascularization through the bilateral internal mammary arteries (BIMA). Both mammaries were harvested endoscopically using the da Vinci robotic system. Further, the "Dresden Technique" was applied for anastomosis of these vessels with the coronaries. RESULTS: All patients survived the surgery. Mean duration of surgery amounted (244 +/- 82.1 min). BIMA dissection took (87 +/- 18.1 min). An average of 2.2 anastomoses were performed per patient. Postoperatively, the patients remained on ICU for 19 +/- 18 hrs. One patient needed reexploration for bleeding (4%). CONCLUSIONS: The addition of robotically enhanced endoscopic mammary artery harvesting method to the "Dresden Technique" for coronary artery surgery enables the introduction of a new treatment method for CAD into surgical practice, helping to perform an arterial revascularization with a distinctly reduced surgical trauma.