13 Semiautomatic coronary anastomosis using cobra and helical needle concept

		Suture with COBRA-Tool. The vessels are to be sutured in an end-to-side arrangement. Approximately 10-12 stitches per anastomosis are required.

In cardiac surgery, increasing attempts are made to reduce the invasiveness of the surgical procedure. In particular, the increasing number and age of patients being subjected to coronary bypass surgery emphasises the need for achieving this goal. Fully endoscopic off-pump coronary artery bypass surgery is considered the ultimate goal of coronary bypass procedures.

Automising the grafting anastomosis process is an important step in the evolution towards minimally invasive heart surgery. This development addresses the solution of several problems related to producing sutures on the beating heart by hand, such as the complexity of trajectory of motion when performing a stitch on a stabilised coronary artery, the influence of surgical factors like wall irregularities, the presence of remnant coronary artery motion even after coronary stabilisation, and the difficulty of maintaining a consistently high level of quality of sutures.

In the course of the Co-Me phase 1 project "Cardiac Robotics", a semi-automated suturing process involving a new device called «Cobra-Tool» with a helical needle and drive unit has been developed. The system produces semi-automatically continuous suture anastomosis using polypropylene threads. Using this novel device, conventional mammary artery grafts to coronary artery end-to-side anastomosis on explanted pig and sheep hearts have successfully been performed. There are six patents pending for the Cobra Tool.

The objectives of phase 2 include the improvement of the tools specification through the solving of technical problems and performing more in vivo animal tests. Another goal is to develop a model to successfully transfer the technology/product into the market.

Sub Projects

13/1 Animal tests and first clinical trials of the anastomotic device

13/2 Improvements of the anastomotic device to maximise the success rate of the animal trials

The goal of this subproject is to significantly reduce the excessive time required for a precise placement of the Cobra tool, optimising the helical needle, testing of grooved needle and improvement of the Lima inversion tool and the helical needle drive.

Project Coordination