Predicting target vessel location for improved planning of robot-assisted CABG procedures

Abstract

Prior to performing a robot-assisted coronary artery bypass grafting procedure, a pre-operative computed tomography scan is used to assess patient candidacy and to identify the location of the target vessel. The surgeon then determines the optimal port locations to ensure proper reach to the target with the robotic instruments, while assuming that the heart does not undergo any significant changes between the pre- and intra-operative stages. However, the peri-operative workflow itself leads to changes in heart position and consequently the intra-operative target vessel location. As such, the pre-operative plan must be adequately updated to adjust the target vessel location to better suit the intra-operative condition. Here we propose a technique to predict the position of the peri-operative target vessel location with ~ 3.5 mm RMS accuracy. We believe this technique will potentially reduce the rate of conversion of robot-assisted procedures to traditional open-chest surgery due to poor planning. © 2010 Springer-Verlag.