{"title":"微创直接冠状动脉搭桥术的全内窥镜胸内动脉采集及有效的设置修改。","authors":"Yoshihiro Goto, Yui Ogihara, Sho Takagi, Junji Yanagisawa, Yasuhide Okawa","doi":"10.5761/atcs.nm.25-00007","DOIUrl":null,"url":null,"abstract":"<p><p>Minimally invasive direct coronary artery bypass grafting for the left anterior descending artery is a well-established technique; however, harvesting the internal thoracic artery is challenging, particularly with endoscopic approaches. In this study, 12 patients underwent internal thoracic artery harvesting using a three-dimensional endoscope with a three-port system (one incision plus two ports). Working space was established by elevating the chest wall upward using hooks anchored at the main incision site. To enhance operability, the positions of the camera and instruments were strategically adjusted within the existing ports, obviating the need for additional access points. All patients achieved graft patency. No complications, such as internal thoracic artery injury, were observed, and no patient required conversion into median sternotomy. This approach minimizes invasiveness while maintaining effectiveness, allowing for adequate dissection of the internal thoracic artery without necessitating expansion of the existing surgical setup.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905077/pdf/","citationCount":"0","resultStr":"{\"title\":\"Totally Endoscopic Internal Thoracic Artery Harvesting with Efficient Setup Modifications for Minimally Invasive Direct Coronary Artery Bypass Grafting.\",\"authors\":\"Yoshihiro Goto, Yui Ogihara, Sho Takagi, Junji Yanagisawa, Yasuhide Okawa\",\"doi\":\"10.5761/atcs.nm.25-00007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Minimally invasive direct coronary artery bypass grafting for the left anterior descending artery is a well-established technique; however, harvesting the internal thoracic artery is challenging, particularly with endoscopic approaches. In this study, 12 patients underwent internal thoracic artery harvesting using a three-dimensional endoscope with a three-port system (one incision plus two ports). Working space was established by elevating the chest wall upward using hooks anchored at the main incision site. To enhance operability, the positions of the camera and instruments were strategically adjusted within the existing ports, obviating the need for additional access points. All patients achieved graft patency. No complications, such as internal thoracic artery injury, were observed, and no patient required conversion into median sternotomy. This approach minimizes invasiveness while maintaining effectiveness, allowing for adequate dissection of the internal thoracic artery without necessitating expansion of the existing surgical setup.</p>\",\"PeriodicalId\":93877,\"journal\":{\"name\":\"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia\",\"volume\":\"31 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905077/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5761/atcs.nm.25-00007\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5761/atcs.nm.25-00007","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Totally Endoscopic Internal Thoracic Artery Harvesting with Efficient Setup Modifications for Minimally Invasive Direct Coronary Artery Bypass Grafting.
Minimally invasive direct coronary artery bypass grafting for the left anterior descending artery is a well-established technique; however, harvesting the internal thoracic artery is challenging, particularly with endoscopic approaches. In this study, 12 patients underwent internal thoracic artery harvesting using a three-dimensional endoscope with a three-port system (one incision plus two ports). Working space was established by elevating the chest wall upward using hooks anchored at the main incision site. To enhance operability, the positions of the camera and instruments were strategically adjusted within the existing ports, obviating the need for additional access points. All patients achieved graft patency. No complications, such as internal thoracic artery injury, were observed, and no patient required conversion into median sternotomy. This approach minimizes invasiveness while maintaining effectiveness, allowing for adequate dissection of the internal thoracic artery without necessitating expansion of the existing surgical setup.