Off-pump totally endoscopic coronary artery bypass (TECAB) requires effective and reliable coronary stabilization. Although the Octopus Nuvo stabilizer has been used for this purpose, its positioning and adjustment may depend on the bedside assistant, which can make precise control challenging.
Technique
A simple robot-arm stabilizer technique allows the console surgeon to directly control coronary stabilization using standard, readily available equipment.
In this technique, the stabilizer head of a standard coronary stabilizer is detached from its shaft and introduced into the chest through a small incision. A robotic cardiac probe grasper, inserted through the fourth robotic arm, grasps the stabilizer head and positions it directly over the target coronary artery.
The console surgeon can then adjust and reposition the stabilizer as needed to optimize exposure and stabilization.
Clinical Application
This technique provides effective coronary stabilization without requiring a dedicated robotic stabilizer. In addition, direct control by the console surgeon enables easy and repeated adjustment of the stabilizer position. The robot-arm stabilizer technique may offer a simple and practical option for performing off-pump TECAB with current-generation robotic systems.
This physician-developed modification represents an off-label use of the coronary stabilizer.
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