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The Future Of Bypass? A Novel Simulator For Robotic Beating Heart Tecab Training
Yazan AlJamal1, Juan Crestanello
2, Joseph A. Dearani
2, Husam H. Balkhy
1.
1University of Chicago, Chicago, IL, USA,
2Mayo Clinic, Rochester, MN, USA.
Objective: To present a beating heart simulator designed to improve robotic Totally Endoscopic Coronary Artery Bypass (TECAB) training. The simulator replicates controlled heart motion to provide hands-on skill-building opportunities in both dry and wet lab environments.
Methods: We purchased the ONiLAB© Digital Rocking Shaker (with adjustable speeds ranging from 10 to 80 RPM) from Amazon©, which mimics the movement of a beating heart. This setup requires the DaVinci Si or Xi robot© with two black diamond forceps, Potts scissors, and a combination of 7-0 and 8-0 monofilament suture In the wet lab, veal hearts obtained from a local grocery store are placed on top of the rocking shaker, with four disposable drape sheets underneath for support. The inclusion of hearts with remnant conduits creates a more realistic surgical environment, allowing trainees to identify, prepare, and suture coronary vessels effectively. In the dry lab, trainees utilize 1.0 to 3.0 mm plastic tubes from Pocket Suture, enabling them to refi their microvascular suturing skills. (picture)
Results: The cost of the simulator is ~ $150. It takes 20 minutes to set up and can be used an unlimited number of times. The simulator effectively replicates beating heart motion, allowing for repeated practice and skill development. Feedback from expert robotic cardiac surgeons indicates that the simulator provides a realistic and practical environment for enhancing suturing techniques and coronary vessel manipulation, making it a valuable addition to surgical training programs.
Conclusions: The simulator's beating heart motion offers a dynamic environment to develop and master the skills needed for robotic beating-heart TECAB. Both dry and wet lab applications support a wide range of training needs, from foundational microvascular techniques to advanced coronary manipulation. With its low cost, reusability, and ease of setup, the simulator is positioned to improve surgical skills in a realistic yet controlled training environment.
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