Endoscopic robot-assisted surgery is a procedure to improve blood flow to the heart. The procedure is done through small incisions on the left side of the chest wall. During the procedure, a section of a blood vessel (graft) is taken from another part of the body and connected to a blocked artery that leads to the heart (coronary artery). The graft allows blood to flow around (bypass) the blocked part of the coronary artery.
Endoscopic robot-assisted coronary artery bypass grafting surgery is different from traditional coronary artery bypass grafting surgery (CABG). Endoscopic surgery is done using surgical instruments that are attached to robotic arms. The surgeon controls the robotic arms to help perform all or part of the surgery. Traditional CABG is done through an incision in the middle of the breast bone (open heart surgery).
Tell a health care provider about:
Any allergies you have.
All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
Any problems you or family members have had with anesthetic medicines.
Any bleeding problems you have.
Any surgeries you have had.
Any medical conditions you have.
Whether you are pregnant or may be pregnant.
What are the risks?
Allergic reactions to medicines or dyes.
Damage to organs inside the chest, such as the left lung, heart, diaphragm, and aorta.
Stroke or heart attack.
Failure of the graft to work properly, or the graft becoming blocked.
Change to open heart surgery if it becomes hard to complete the procedure using the robot-assisted method.
What happens before the procedure?
- Ask your health care provider about:
Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
Taking over-the-counter medicines, vitamins, herbs, and supplements.
Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
Eating and drinking restrictions
8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
6 hours before the procedure – stop drinking milk or drinks that contain milk.
2 hours before the procedure – stop drinking clear liquids.
Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
A special catheter may be placed in your back to control pain. This is called epidural analgesia.
Plan to have a responsible adult take you home from the hospital or clinic.
Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
- Ask your health care provider what steps will be taken to prevent infection. These may include:
Removing hair at the surgery site.
Washing skin with a germ-killing soap.
What happens during the procedure?
An IV will be inserted into one of your veins.
- You will be given one or both of the following:
A medicine to help you relax (sedative).
A medicine to make you fall asleep (general anesthetic).
A breathing tube may be placed in your throat. It will be connected to a machine that helps you breathe (ventilator).
A thin tube (catheter) may be placed in your urethra to drain your urine during the procedure.
Several small incisions will be made in your chest.
Your left lung will be collapsed to expose the heart and the internal thoracic artery. This is done by removing air from the lung.
An endoscope will be inserted into one of your incisions. Instruments will be placed through other incisions to perform the surgery.
A section of a healthy blood vessel will be removed from your breast area. This will be the graft.
You may be placed on a heart-lung bypass machine if needed. For this, a small incision will be made in your groin. This will give you oxygen while the heart is repaired.
The graft will be attached to the damaged coronary artery with stitches (sutures). It will be sewn above and below the blocked part of the coronary artery to allow blood to bypass the blockage.
When the bypass is done, you will be taken off the heart-lung machine if it was used.
If your heart was stopped, it will be restarted to pump blood again.
Your incisions will be closed with sutures.
Tubes may be placed in your chest to help drain excess fluid (drainage tubes). These will be removed before you leave the hospital.
Your incisions will be covered with a bandage (dressing).
This procedure may vary among health care providers and hospitals.
What happens after the procedure?
Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
You will be given pain medicine as needed.
- You may continue to have:
An IV giving you fluids.
A breathing tube and ventilator helping you to breathe.
A catheter draining your urine.
Drainage tubes in your chest.
You may have to wear compression stockings. These stockings help prevent blood clots and reduce swelling in your legs.
Do not drive until your health care provider approves.
Coronary artery bypass grafting (CABG) is a procedure to improve blood flow to the heart. Endoscopic robotic-assisted CABG is a form of surgery that is done through small incisions using an endoscope and robots.
This procedure is safe, but complications sometimes occur. These may include infection, bleeding, and damage to organs inside your chest.
You may have to undergo a traditional, open CABG surgery if your health care team faces problems while doing the minimally invasive procedure.
After the procedure, you will be monitored in the hospital. You may have to wear compression stockings to prevent blood clots.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.