New Approaches to Coronary Artery Bypass Grafting (CABG) | Mission Statement | Traditional Coronary Artery Bypass Surgery | Totally Endoscopic, Minimally Invasive Coronary Bypass Surgery | Minimally Invasive Direct Coronary Bypass Surgery | Hybrid Coronary Intervention | Advantages of Off-Pump Surgery | Success Stories | New Advances | Robot-Assisted Triple Bypass | Robotic Heart Surgery Video
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Totally endoscopic coronary artery bypass (TECAB) is the least invasive coronary artery bypass grafting operation. The bypass graft is placed through tiny holes without any opening of the chest. In comparison to coronary artery bypass grafting procedures, which are carried out through very small openings in the chest -- mini-thoracotomies -- (MIDCAB, SVST), the operation is performed only through these small portholes. As a result, the surgical trauma and scarring for the patient are very minimal.
The surgeon uses a surgical robot for the procedure, which enables the surgeon to perform complex surgical maneuvers inside the chest. The surgeon inserts a video camera, which is mounted on the operation robot, into the chest and uses two or three additional instruments on the robotic arms.
Robot-assisted minimally invasive surgery provides the benefits of traditional minimally invasive or laparoscopic surgery, but with important technological improvements, including:
The bypass vessels are prepared inside the chest and no cutting of the leg or arms is necessary. A very small incision is made in the groin for connection of the heart-lung machine. A sophisticated special heart-lung machine system is used for these operations. This system serves as a safety net for the patient and takes over the blood circulation while the heart is stopped for the bypass graft connection. The surgeon is working on vessels that are approximately 2 to 3 millimeters in diameter. A stopped heart and the robotic system ensure very accurate suturing of tiny bypass grafts.
After the bypass grafts have been placed and the heart-lung machine is removed, the surgeon and his team check the quality of the grafts by an angiographic exam, which is done while the patient is still under general anesthesia.
Watch the TECAB procedure being performed.
After the operation, the patient is transported to an intensive care unit for postoperative observation. The patient will be on a ventilator for several hours. The doctors watch carefully for adequate heart function. This requires monitors and lines connected to the body for several hours. Patients can drink, eat and walk around very quickly and are discharged home usually within four to five days after the operation.
In the robot-assisted procedure, small incisions are made between the ribs, which helps to reduce pain, scarring, blood loss and the risk of infection.
The minimally invasive TECAB procedure eliminates the need for a large (6-10 inch) incision made down the sternum (breastbone) to access the heart, which reduces a patient's surgical trauma. Other potential patient benefits include:
You can also learn more by reading about our patients' experiences.
For more information or to schedule an appointment, please call 410-328-9169.