What is totally endoscopic coronary artery bypass grafting (CABG)?

Updated: Dec 04, 2019
  • Author: Rohit Shahani, MD, MS, MCh; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Endoscopic surgical techniques with robotic assistance were developed to enable the performance of surgery in difficult spaces; they are widely used across most surgical disciplines. The specific application of these techniques to the treatment of coronary artery disease (CAD) is known as totally endoscopic CABG. Totally endoscopic CABG, which aims to decrease postoperative morbidity, duration of hospital stay, and overall cost, allows surgeons to perform endoscopic surgery on both the beating and arrested heart. [57]

The first step in totally endoscopic CABG is to deflate the lung. Next, three small incisions are made at the intercostal spaces, through which one robotic arm with an attached endoscope and two arms carrying surgical accessories are passed. These arms are controlled by the operator from a unit located away from the operating table. Grafts are then harvested from suitable sites, and an anastomosis is completed across the affected coronary artery. [58]

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