HOW TO ROBOTICALLY HARVEST THE INTERNAL MAMMARY ARTERY IN A SKELETONIZED FASHION USING A BIPOLAR MICRO FORCEPS

Tugba Arslan, Wouter Oosterlinck

 

INTRODUCTION

 

In low mortality cardiac procedures, the paradigm is

changing to a minimally invasive approach, mini-mizing thoracic trauma and avoiding cardio-pulmonary bypass (1,2). In Europe, more than 95% of MIDCAB procedures are performed on a beating heart (3), providing excellent long-term outcomes in coronary revascularization (3–9). The quality of the mammary graft is mainly defined by the degree of trauma to the artery during harvest. The superiority of bipolar cauterization of the side branches was documented before in animal studies (10,11).

 

METHODS

 

We present a video report focusing on the technical usage of a bipolar micro forceps for optimal skeletonized single and bilateral internal mammary artery harvesting in robotic surgery. For this procedure, bipolar energy was set to cautery level 8 to ensure effective hemostasis, while monopolar energy was adjusted to level 1 to allow for precise dissection with minimal thermal collateral damage.

 

RESULTS

 

A bipolar micro forceps combines safe tissue handling and bipolar cauterization, additionally avoiding the frequent change of instruments and decreasing harvesting time.

 

 

VIDEO DEMONSTRATION

 

CONCLUSION

 

A bipolar micro forceps is a practical and safe instrument for internal mammary harvesting that decreases harvesting time by avoiding frequent change of instruments.

 

REFERENCES

 

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