Robotic Bypass Plus Stented Angioplasty

Combining robotically assisted coronary artery bypass surgery (CABG) with stented angioplasty shows promise for treating extensive coronary artery disease.

The findings were reported in a study that involved patients with multi-vessel coronary disease, including obstruction of the left anterior descending coronary artery (LAD), the main artery in the front of the heart. The findings were reported at the American Heart Association Scientific Sessions held in Chicago (IL, USA) in November 2005.

During the closed-chest bypass procedure, the left internal mammary artery was harvested. Doctors then sutured the mammary artery to the obstructed left anterior descending artery (LAD), bypassing the obstruction.

The robotic surgery involved making three small incisions, each about 1-cm long, in the left side of the patient's chest. A three-dimensional (3D) endoscope with 10x magnification was inserted in the middle port, with the robotic right and left arms in the other ports. The surgeon's usual surgical hand movements are translated through the miniature robotic arms inside the patient, precisely following the surgeon's hand movements. During the angioplasty procedure, doctors used stents, both conventional and coated, to unblock other arteries and then prop them open.

"Robotic surgery is much less invasive than regular CABG operations, and patients recover much more quickly with less pain, less scarring, and less disability.” said Dr. Marc R. Katz, lead author of the study and director and chief of cardiac surgery of the Virginia Transplant Center at Henrico Doctors' Hospital (Richmond, VA, USA). "And they were back to work in a week or so, compared with the usual six to 12 weeks.”




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