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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. Instead, the procedure is done endoscopically. The surgery can be done to correct problems with one or more arteries.

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.

Traditional open heart surgery incision

Traditional open heart surgery incision

Robotically assisted surgery incision

Robotically assisted heart surgery incision


Robotically assisted CABG surgery

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 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 can also be combined with coronary artery stenting.

During the robotic assisted procedure, the surgeon controls the instruments, which are mounted on robotic arms attached to a console. The procedure can be done while the patient is on a heart-lung bypass machine (with the heart stopped) or while the heart is beating.

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

Robotic TECAB surgery is performed by specially trained cardiovascular surgeons. Cleveland Clinic Heart Surgeons who perform robotic-assisted bypass surgery include:

Cleveland Clinic Heart Surgeons who perform minimally invasive bypass surgery include:

Some of these surgeons perform only specific types of robotically assisted heart surgery. 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 learn more about 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: 05/15

Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.

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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.

© Copyright 2015 Cleveland Clinic. All rights reserved.

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