A Novel Robotic Bilateral Internal Mammary Artery Harvest Using Double Docking Technique for Coronary Artery Bypass Grafting

Abstract

da Vinci Surgical System (da Vinci) enabled port access for internal mammary arteries (IMA) harvesting. However, bilateral IMA (BIMA) harvesting is difficult when performed on single side. We developed a novel technique of double docking the da Vinci by transpositioning from the left side to the right and examined the feasibility. Twelve patients underwent BIMA harvesting using the double-docking technique. First, the da Vinci was set on the patient's left side for the right IMA harvesting. Afterward, the da Vinci was undocked and transpositioned from the patient's left side to the right side. The time elapsed during rotation was measured. Subsequently, the left IMA was harvested from patient's right side. Distal anastomoses were performed by a small anterolateral thoracotomy. All of the IMAs were harvested and then bypassed without damage. The mean ± SD time that elapsed during rotation was 6.5 ± 0.6 minutes. There was no conversion to sternotomy. Bilateral IMA harvesting by the bilateral docking technique was performed successfully with acceptable feasibility.