Robotically Assisted Coronary Bypass Surgery

Robotically assisted coronary artery bypass (CABG) surgery is a type of minimally invasive heart surgery performed by a cardiac surgeon. The surgery involves the coronary arteries, but the surgeon does not need to open the chest in the traditional manner. Instead, the procedure is done partially or totally endoscopically. The surgery can be done to correct problems with one or more arteries.

Traditional open heart surgery incision

Traditional open heart surgery incision

Robotically assisted total endoscopic coronary artery bypass surgery(TECAB) incision

Robotically assisted total endoscopic coronary artery bypass surgery  (TECAB) incision

Robotically assisted direct coronary artery bypass surgery <b>(MIDCAB)</b> incision

Robotically assisted direct coronary artery bypass surgery (MIDCAB) incision

Robotically Assisted Coronary Artery Bypass Surgery: Smaller incision

Traditional, open-chest bypass surgery requires an 8-inch incision through the breastbone. The surgeon spreads the sternum to view the heart and then places the bypasses under direct vision.

The incisions used in robotically assisted CABG surgery are even smaller than those used in traditional minimally invasive surgery. There are three ways the robot can be used to perform bypass surgery:

Totally endoscopic coronary artery bypass (TECAB): The surgeon does not need to open the chest. Instead, the procedure is done completely endoscopically. The surgeon makes four or five tiny incisions (also called “port holes”). The incisions are used to insert the camera and instruments, and to stabilize the heart. There is also an assistant port. The internal mammary artery (IMA), which runs along the chest wall, is the blood vessel used for the bypass. It is robotically connected to the coronary artery behind the blockage.

Robot assisted Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) surgery: In this surgery, the robot is used to access the IMA artery and the surgeon performs the bypass surgery using a small incision between the ribs on the left chest.

Hybrid procedure: Robotic TECAB, robotically assisted MIDCAB and non-robotic MIDCAB can also be combined with coronary artery stenting.  

What are the benefits of robotically assisted surgery?

Compared with traditional surgery, the benefits of robotically assisted surgery include:

  • High level of precision by up-to 10-fold magnification with the robotic camera.
  • Smaller incisions allow for faster healing and minimal scarring.
  • Shorter hospital stay.
  • Shorter recovery and quicker return to daily and professional activities. The patient can resume normal activities and work as soon as he or she feels up to it. There are no specific activity restrictions after robotically assisted surgery. Patients usually feel like they’re back to normal in three to four weeks after surgery.
  • Decreased risk of infection.

Not all patients are able to have robotically assisted bypass surgery

The patient’s records and test results are carefully reviewed by the surgeon to determine if the patient is a candidate for robotically assisted CABG surgery. At this time, patients who have very poor lung function or who need a re-operation are not candidates for this type of procedure. Patients who need emergency surgery are also excluded.

The patient will talk to the surgeon about which surgery best meets the individual’s needs. If robotic surgery is not an option, another minimally invasive approach may be an option. In other cases, a traditional approach is the best and safest option for the patient.

Robotically assisted bypass surgery

Robotically assisted heart surgery

For more information about coronary artery bypass surgery:

Surgeons who perform robotically assisted bypass surgery

Cleveland Clinic Heart Surgeons who perform different types of robotic-assisted bypass surgery include:

Cleveland Clinic Heart Surgeons who perform minimally invasive bypass surgery (non-robotic MIDCAB) include:

We would be happy to help you find the right surgeon to treat your medical condition.

If you would like to find out if you are a candidate for robot-assisted CABG surgery or minimally invasive heart surgery, contact us or call the Miller Family Heart & Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We are happy to help you.

Reviewed: 06/15

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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