A Novel Method for Auto-Suturing in Laparoscopic Robotic-Assisted Coronary Artery Bypass Graft (CABG) Anastomosis

Coronary Heart Disease (CHD), which results from buildup of plaque in the heart’s coronary arteries, accounts for 12.2% of all deaths worldwide. There are two major ways to treat CHD: if the plaque level is high (above ~70% blockage), then open-heart surgery is usually performed. However, if the plaque level is moderate (~40% to 70%), then a drug-eluting stent can be placed in the artery to hold the plaque back from interfering with the blood flow and reduce restenosis. Laparoscopic heart surgery, or heart surgery conducted through small holes made between the ribs and on the sides of the chest, has increasingly been used over traditional coronary artery bypass graft (CABG) surgery, however, laparoscopic robotic-assisted CABG surgery has shown many advantages in research over both. Despite improvements, these traditional operations still take vast amounts of time and can result in infection or other complications. In this study, we developed auto-sutures that are automated through the use of a helical suture needle. Due to the significant decrease of time to suture, we increased the amount of sutures per segment of the auto-sutured CABG anastomosis. The quality of the auto-sutures was tested in a tensile test as well as a burst test apparatuses designed for this research. A burst test was simulated by pumping a blood-mimicking solution into silicon tubing. In all 80 experiments conducted (40 tensile test & 40 burst test), five sutures per segment was the optimal suturing method, as it had the highest maximum pressure as well as second-highest tensile strength.