293 posters, 56 videos, 24 topics, 13 sessions, 658 authors, 215 institutions

ISMICS 2025 Annual Meeting

28 - 31 May, 2025 | Istanbul, Turkey

P24

Development Of A Totally Robotic Beating Heart Coronary Artery Bypass Graft Program; Simulation To Clinical Practice

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Poster Presenter

Michael Wilson

Authors

Michael Wilson, Henry Wilson, Veronica Preda, Steven Agiasotis, Abirami Puvanendran, Terry Carney, Martin Ng

Affiliations

Surgical XR, 2 Technology Place, Macquarie Park, Sydney Australia., Faculty of Medicine, Health and Human Sciences, Macquarie University Macquarie Park, Sydney Australia and Macquarie University Hospital, 2 Technology Place, Macquarie Park, Sydney Australia, Surgical XR, 2 Technology Place, Macquarie Park. Faculty of Medicine, Health and Human Sciences, Macquarie University Macquarie Park, 2 Technology Place, Macquarie Park, Faculty of Medicine, Health and Human Sciences, Macquarie University Macquarie Park

Part of Topic

Coronary Revasc plus

Introduction/Background

Despite a decade of Da Vinci AUS robotics TECABG has not been performed.

TECABG is the logical MICS extension of existing OFF pump AAA CABG and Robotic MIDCABG programs. DaVinci coronary

stabilisers are not available in AUS
When the Torregrassa Gell-port Medtronic Nuovo stabiliser system makes TECAB possible we committed to starting a program.
Challenges: Isolation, small case numbers, Robotic access blocked by prostates

Methodology

Minimum requirements Skills:

1. Well trained coronary robotic team

2. OFF-pump CABG: Anaortic All Arterial

3. MICS skills RATS and MID-CABG.

4. ECMO: peripheral and wire skills

5. Micro-suture robotic platform & equipment

6. Minimally invasive stabiliser

Lead surgeon experience

80% off pump CAGS 100+ da Vinci MID-CABG
Active in TAVI and da Vinci mitral repair programs
SXR Image capture stream store & analyse platform & 360

room cam for team analysis developed Program started after:

Ethics research and credentialling approved
3 successful Sims anastomotic time < 20’
Operating team comfortable with simulation
Consensus from northern hemisphere experts that it was

safe to proceed

Conclusion

5/5 Successful Cases;
- 4: LIMA-LAD
- 1: RIMA-LAD LIMA- D-1
DaV ave console time 245’, op time 290’
No infarcts or conversion
Mean LOS 5
Enhanced recovery

High fidelity simulation
Allows technically demanding innovation in small volume remote site to be safely initiated
SXR: platform used to score and analyse the procedural steps, including salvage sim to develop minimum standards of team procedural function
Streaming and Networking with Northern Hemisphere colleagues is facilitated

This benchmarking collaboration and simulation approach allowed the safe introduction of a challenging procedure.