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87. Robotic surgery using Zeus MicroWrist technology: the next generation.

Author

Isgro F, Kiessling A, Blome M, Lehmann A, Kumle B, Saggau W, Isgro, Frank, Kiessling, Arndt-Holger, Blome, Markus, Lehmann, Andreas, Kumle, Bernhard, and Saggau, Werner

Abstract

Background: The use of computer-animated surgical instruments for various cardiac operations has been shown to be feasible, but to date, the available information regarding the operative and technical details of these procedures is still inadequate.Methods: We used the Zeus (Computer Motion Inc., Goleta, Calif, USA) telemanipulation system to perform the internal mammary artery (IMA) takedown in 56 patients, in 12 of whom we used the newest model with MicroWristTM (Computer Motion Inc., Goleta, Calif, USA) technology. Port orientation was based on thoracic anatomy, the decisive landmarks being the mammillary line and the axillary line. The distance between ports was at least 9 cm, and the patient's arm was positioned with the left shoulder raised and angulated by not more than 90 degrees.Results: Mean setup time was 44 +/- 18 minutes for the first five patients and 16 +/- 7 minutes for the last five patients, with an overall average of 24 +/- 12 minutes. IMA harvest time at the beginning reached a mean of 95 +/- 23 minutes and decreased to 44 +/- 18 minutes in the last five cases. Average IMA takedown time was 58 +/- 17 minutes. The IMA was patent with a good flow in all 56 patients.Conclusions: The introduction of robotic technology into clinical routine has resulted in safe procedures with a short learning curve. However, basic training in the modality is a must in order to achieve technical excellence. [ABSTRACT FROM AUTHOR]

Published
2003
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90. Defibrillation Efficacy Comparing a Subcutaneous Array Electrode versus an 'Active Can' Implantable Cardioverter Defibrillator and a Subcutaneous Array Electrode in Addition to an 'Active Can' Implantable Cardioverter Defibrillator: Results from Active...

Author

Gradaus R, Block M, Seidl K, Brunn J, Isgro F, Hammel D, Hauer B, Breithardt G, and Böcker D

Abstract

Introduction: Placement of implantable cardioverter defibrillators (ICDs) has been simplified by using the shell of a pectorally implanted ICD as a defibrillation electrode in combination with an endocardial right ventricular defibrillation lead. However, a sufficiently low defibrillation threshold (DFT) cannot be obtained in a few patients. Therefore, alternative approaches were systematically tested in the Active Can versus Array Trial (ACAT). Methods and Results: In the first of two prospective randomized studies, the DFT of a subcutaneous left dorsolateral array anode introduced from a pectoral incision was compared to that of a standard active can anode in 68 patients. Intraoperatively, the DFT was determined twice in each patient using either the active can or, in patients with a subcutaneous array lead, once with all three fingers and once omitting the middle finger of the array. The second prospective randomized study included 40 patients. DFT also was determined twice in each patient using an active can in a left pectoral position as anode alone and combined with a left dorsolateral array electrode with two fingers. In ACAT I, stored energy at DFT decreased from 13.1 ± 7.7 J (active can) to 9.6 ± 6.1 J (three-finger array lead) (P = 0.04), impedance decreased from 53 ± 8 to 40 ± 6 (P < 0.0001). Omitting the middle finger of the array lead, stored energy at DFT increased by 0.9 J (P = 0.47) and impedance by 2 (P < 0.0001). In ACAT II, DFT and impedance using an active can device were significantly lower when a two-finger array lead was added that decreased stored energy at DFT from 10.1 ± 5.2 J to 6.9 ± 3.9 J (P = 0.001) and impedance from 56 ± 5 to 42 ± 5 (P < 0.0001). Conclusion: In combination with a right ventricular defibrillation electrode, a left pectoral subcutaneous array lead improves defibrillation efficacy if used instead of, or in addition to, a left pectoral active can ICD device. Implantation of the array lead can be simplified by using two instead of three fingers, without a significant loss of defibrillation efficacy. [ABSTRACT FROM AUTHOR]

Published
2001
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95. The JEM-EUSO Mission: Contributions to the ICRC 2013

Author

Adams, JEM EUSO Collaboration (. J. H., J. r., Polytech, S. Ahmad (. E. c., Palaiseau, Albert, J. N., Allard, D., Anchordoqui, L., Andreev, V., Anzalone, A., Arai, Y., Asano, K., Ave Pernas, M., Barrillon, P., Batsch, T., Bayer, J., Belenguer, T., Bellotti, R., Belov, K., Berlind, A. A., Bertaina, M., Biermann, P. L., Biktemerova, S., Blaksley, C., Blanc, N., Blecki, J., Polytech, S. Blin Bondil (. E. c., Blumer, J., Bobik, P., Bogomilov, M., Bonamente, M., Briggs, M. S., Briz, S., Bruno, A., Cafagna, F., Campana, D., Capdevielle, J. N., Caruso, Rossella, Casolino, M., Cassardo, C., Castellini, G., Catalano, C., Catalano, O., Cellino, A., Chikawa, M., Christl, M. J., Cline, D., Connaughton, V., Conti, L., Cordero, G., Crawford, H. J., Cremonini, R., Csorna, S., Dagoret Campagne, S., De Castro, A. J., De Donato, C., Polytech, C. de la Taille (. E. c., De Santis, C., del Peral, L., Dell'Oro, A., De Simone, N., Di Martino, M., Distratis, G., Polytech, F. Dulucq (. E. c., Dupieux, M., Ebersoldt, A., Ebisuzaki, T., Engel, R., Falk, S., Fang, K., Fenu, F., Fernandez Gomez, I., Ferrarese, S., Finco, D., Flamini, M., Fornaro, C., Franceschi, A., Fujimoto, J., Fukushima, M., Galeotti, P., Garipov, G., Geary, J., Gelmini, G., Giraudo, G., Gonchar, M., Gonzalez Alvarado, C., Gorodetzky, P., Guarino, F., Guzman, A., Hachisu, Y., Harlov, B., Haungs, A., Hernandez Carretero, J., Higashide, K., Ikeda, D., Ikeda, H., Inoue, N., Inoue, S., Insolia, A., Isgro, F., Itow, Y., Joven, E., Judd, E. G., Jung, A., Kajino, F., Kajino, T., Kaneko, I., Karadzhov, Y., Karczmarczyk, J., Karus, M., Katahira, K., Kawai, K., Kawasaki, Y., Keilhauer, B., Khrenov, B. A., Jeong Sook Kim, Soon Wook Kim, Sug Whan Kim, Kleifges, M., Klimov, P. A., Kolev, D., Kreykenbohm, I., Kudela, K., Kurihara, Y., Kusenko, A., Kuznetsov, E., Lacombe, M., Lachaud, C., Lee, J., Licandro, J., Lim, H., Lopez, F., Maccarone, M. C., Mannheim, K., Maravilla, D., Marcelli, L., Marini, A., Martinez, O., Masciantonio, G., Mase, K., Matev, R., Medina Tanco, G., Mernik, T., Miyamoto, H., Miyazaki, Y., Mizumoto, Y., Modestino, G., Monaco, A., Monnier Ragaigne, D., Morales de los Rios, J. A., Moretto, C., Morozenko, V. S., Mot, B., Murakami, T., Nagano, M., Nagata, M., Nagataki, S., Nakamura, T., Napolitano, T., Naumov, D., Nava, R., Neronov, A., Nomoto, K., Nonaka, T., Ogawa, T., Ogio, S., Ohmori, H., Olinto, A. V., Orleanski, P., Osteria, G., Panasyuk, M. I., Parizot, E., Park, I. H., Park, H. W., Pastircak, B., Patzak, T., Paul, T., Pennypacker, C., Perez Cano, S., Peter, T., Picozza, P., Pierog, T., Piotrowski, L. W., Piraino, S., Plebaniak, Z., Pollini, A., Prat, P., Prevot, G., Prieto, H., Putis, M., Reardon, P., Reyes, M., Ricci, M., Rodriguez, I., Rodriguez Frias, M. D., Ronga, F., Roth, M., Rothkaehl, H., Roudil, G., Rusinov, I., Rybczynski, M., Sabau, M. D., Saez Cano, G., Sagawa, H., Saito, A., Sakaki, N., Sakata, M., Salazar, H., Sanchez, S., Santangelo, A., Santiago Cruz, L., Sanz Palomino, M., Saprykin, O., Sarazin, F., Sato, H., Sato, M., Schanz, T., Schieler, H., Scotti, V., Segreto, A., Selmane, S., Semikoz, D., Serra, M., Sharakin, S., Shibata, T., Shimizu, H. M., Shinozaki, K., Shirahama, T., Siemieniec Ozieblo, G., Silva Lopez, H. H., Sledd, J., Slominska, K., Sobey, A., Sugiyama, T., Supanitsky, D., Suzuki, M., Szabelska, B., Szabelski, J., Tajima, F., Tajima, N., Tajima, T., Takahashi, Y., Takami, H., Takeda, M., Takizawa, Y., Tenzer, C., Tibolla, O., Tkachev, L., Tokuno, H., Tomida, T., Tone, N., Toscano, S., Trillaud, F., Tsenov, R., Tsunesada, Y., Tsuno, K., Tymieniecka, T., Uchihori, Y., Unger, M., Vaduvescu, O., Valdes Galicia, J. F., Vallania, P., Valore, L., Vankova, G., Vigorito, C., Villasenor, L., von Ballmoos, P., Wada, S., Watanabe, J., Watanabe, S., J. Watts J. r., Weber, M., Weiler, T. J., Wibig, T., Wiencke, L., Wille, M., Wilms, J., Z. W. l., Yamamoto, T., Yamamoto, Y., Yang, J., Yano, H., Yashin, I. V., Yonetoku, D., Yoshida, K., Yoshida, S., Young, R., Zotov, M. Y. u., and Zuccaro Marchi, A.

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