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Robotically Assisted Beating Heart Totally Endoscopic Coronary Artery Bypass (TECAB). Is There a Future?
Sudhir Srivastava1, Suresh Gadasalli, Madhava Agusala
1From the *Alliance Hospital; †Cardiac Surgical Associates of West Texas, Odessa, TX; ‡Intuitive Surgical Inc, Sunnyvale, CA; and §The University of Chicago Medical Center, Chicago, IL.
Innovations (Philadelphia, Pa.)
|March 23, 2012
Summary
Robotic-assisted beating heart totally endoscopic coronary artery bypass (TECAB) offers a less invasive option for select patients. This technique demonstrated excellent graft patency and no in-hospital mortality in a recent study.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Robotic Surgery
Background:
- Beating heart totally endoscopic coronary artery bypass (TECAB) has shown promise but faces limited adoption.
- Robotic assistance may enhance TECAB procedures, improving outcomes and patient selection.
Purpose of the Study:
- To report the authors' experience with robotic-assisted beating heart TECAB.
- To evaluate the potential for future adoption of this minimally invasive technique.
Main Methods:
- 93 patients underwent beating heart TECAB between July 2004 and December 2005.
- Procedures utilized port incisions for robotic arms and an endostabilizer, with internal thoracic arteries as conduits.
- Anastomoses were secured using surgical U-clips; 19.4% of patients had planned hybrid revascularization.
Main Results:
- No in-hospital mortality, myocardial infarction, or cerebrovascular accident (CVA) occurred.
- Mean operative time was 272.6 minutes, with a mean anastomotic time of 13.8 minutes.
- Mean hospital stay was 3.4 days, and 100% graft patency (122/122 grafts) was observed.
Conclusions:
- Beating heart TECAB, with or without hybrid revascularization, provides a less invasive surgical approach.
- This technique is suitable for a carefully selected patient group requiring coronary artery bypass grafting.
