Single-Center Initial Experience with Robotic Assisted Minimally Invasive Coronary Artery Bypass Surgery.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic assisted minimally invasive direct coronary artery bypass grafting (RA-MIDCAB) is an alternative to conventional coronary artery bypass grafting for left anterior descending artery (LAD) revascularization using the left internal thoracic artery (LITA).
• Since the first robotic LITA-LAD bypass in 1998, advancements have focused on reducing surgical trauma and accelerating patient recovery.
• This report details the initial single-center experience with RA-MIDCAB surgery.

Purpose of the Study:

• To evaluate the safety and efficacy of RA-MIDCAB surgery.
• To assess perioperative and postoperative outcomes in patients undergoing RA-MIDCAB.
• To determine the feasibility of establishing a RA-MIDCAB program.

Main Methods:

• A retrospective review of the first 27 RA-MIDCAB patients between July 2024 and September 2025.
• Collection of baseline characteristics, perioperative, and postoperative data from institutional records.
• Successful completion of all procedures by two expert surgeons with intraoperative graft patency assessment.

Main Results:

• All RA-MIDCAB procedures were successfully completed with no mortality at 30 days or long-term, and no conversions to sternotomy.
• Mean surgery time was 245.7 minutes, with low rates of new onset atrial fibrillation (7.4%) and respiratory failure (3.7%).
• Mean intensive care unit and hospital stays were 2.4 and 3.9 days, respectively, with no repeat revascularizations or major adverse cardiovascular events.

Conclusions:

• RA-MIDCAB surgery can be performed safely and yields excellent clinical results.
• Implementing a RA-MIDCAB program can enhance the quality of patient care.
• The initial experience demonstrates the viability and benefits of robotic-assisted CABG.