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Gewählte Publikation:

Bergmann, P; Huber, S; Segl, H; Maechler, H; Reiter, U; Reiter, G; Rienmueller, R; Oberwalder, P; Rigler, B.
Cardiac MR in robotic heart surgery for preoperative identification of the target vessel and precise port placement--a theoretical model.
Thorac Cardiovasc Surg. 2003; 51(4):204-10 Doi: 10.1055/s-2003-42263
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Co-Autor*innen der Med Uni Graz
Huber Stefan
Mächler Heinrich
Oberwalder Peter
Reiter Ursula
Rienmüller Rainer
Rigler Bruno
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Abstract:
BACKGROUND: The identification of the ideal anastomosis site and the proper port placement are critical for the success of closed-chest robotic surgery. We investigated a new systematic procedure for precise port placement for TECABs. METHODS: We used trigonometry and a human thoracic model to determine the optimal working angles between anastomotic plane, instruments, and endoscope. We then applied the results to seven human subjects as follows: 1. A navigation grid was located extrathoracically before cardiac MR examination. 2. The ideal anastomosis site was defined with the MR. Intrathoracic distances and angles were computed with cardiac MR software and projected onto the thorax. 3. The ideal port placement points were marked on the thorax. RESULTS: The optimal working angle between endoscope and instruments was 35 degrees. 0 degrees and 90 degrees angles were associated with a significant reduction in visualization, technical ease, quality and anastomosis time. The course of the LAD was identified in all seven volunteers with MR. Mean deviation of the endoscope port from the medioclavicular line was 4.3+/-2.1 cm and of the instrument ports from the anterior axillary line 8.4+/-2.4 cm. CONCLUSIONS: Cardiac MR in combination with the navigation grid proved suitable for the visualization of coronary vessels for individually calculating port placement points on the thorax.
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Computer Simulation - administration & dosage
Coronary Artery Bypass - administration & dosage
Coronary Vessels - anatomy & histology
Endoscopy - administration & dosage
Heart - anatomy & histology
Humans - administration & dosage
Imaging, Three-Dimensional - administration & dosage
Magnetic Resonance Imaging - administration & dosage
Male - administration & dosage
Models, Structural - administration & dosage
Phantoms, Imaging - administration & dosage
Robotics - administration & dosage

Find related publications in this database (Keywords)
robotic surgery
navigation
port placement
TECAB
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