Totally endoscopic coronary artery bypass (TECAB) surgery is a highly advanced approach to coronary bypass surgery (CABG). Performed through tiny slits using the daVinci Robot, this is a completely closed chest surgery. TECAB is performed by very few cardiac surgeons because it is a technically demanding procedure that involves specialized skills and training. This advanced technique requires that the entire surgical team--including nurses and other specialists--be experienced with this approach.
How is TECAB performed?
TECAB is used to perform the same function as a traditional coronary bypass procedure – to improve blood flow to the heart and to alleviate chest pain. However, instead of an open chest procedure, TECAB is performed through tiny slits using the daVinci Surgical System.
The robot allows the surgeon to perform the procedure with greater precision and control than is possible in traditional hands-on surgery. The robotic arms are very agile and work as an extension of the surgeon's hands. A tiny camera attached to the robotic arms gives the surgeon a very detailed, three-dimensional view of the operating space inside the chest.
The entire operation is performed as a closed-chest procedure. The heart continues to beat during the surgery and no heart-lung bypass machine is required. Internal artery grafts are most commonly used, so grafts are rarely harvested from other parts of the body, such as the arm or leg. The daVinci robot makes it easier and safer for the surgeon to harvest these grafts.
For patients who need both surgical and interventional cardiology procedures to improve blood flow to the heart, the surgeons at PHCVI will perform a hybrid TECAB. This procedure involves bypassing some blocked arteries using TECAB, and opening others via angioplasty (which may include stent placement to prop open blocked arteries).
What are the benefits of TECAB?
Totally endoscopic coronary artery bypass surgery offers many benefits for patients including:
No splitting of the breastbone.
Shorter hospital stay.
Heart continues to beat during the procedure.
Elimination of the heart-lung bypass machine
Minimal blood loss and less need for transfusion
Internal mammary artery grafts.
TECAB is a good option for people of any age who require coronary artery bypass surgery. For the elderly, TECAB avoids complications with weakened bones due to osteoporosis.
As with any surgery, the hospital stay and recovery time vary depending upon the overall health of the patient and other associated risk factors.