19 декабря 2001 00:00 |
Totally endoscopic myocardial revascularization
(experimental study).
46 human cadavers were operated on in order to develop a surgical approach of totally endoscopic myocardial revascularization. A right gastroepiploic artery (RGEA) was harvested endoscopically in all cases through 3 troacars inserted into abdominal cavity. The average length of conduit was: in human 27+−2.5cm. The meantime of harvest was 45min+−25 min. Then a hole of 50 mm was made in the corpus tendineum of diaphrahm to exposure the right coronary artery (RCA). With the help of two vacuum pods inserted in pericardium via 10 mm extra insisions we stabilized a site of the RCA and made a RGEA-RCA anastomosis using endoscopic instruments. In 20 cases continuous prolene suture was used and in 26 experiments we applied a sutureless technique. A patency rate was 50% (23 anastomosis were patent). Despite comparatively low patency rate the transabdominal approach of totally endoscopic bypass grafting is promising and demanding furhter investigation.
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