Robot Assisted Triple Bypass Surgery
Minimally Invasive Coronary Bypass Surgery
Robot-Assisted Triple Bypass Heart Surgery at the University of Maryland Medical Center
The majority of patients who require bypass surgery have more than two blocked arteries going to the heart. The ability to bypass three vessels now means that many more patients can benefit from this minimally invasive, robot-assisted heart surgery, known as robot-assisted totally endoscopic coronary artery bypass (TECAB).
This procedure, which does not require any large incisions, presents a durable alternative to open heart surgery for patients with multiple blocked coronary arteries. The University of Maryland Medical Center is only the second place in the United States to have performed robot-assisted triple bypass and the first in the world to achieve the triple bypass using an advanced, minimally-invasive heart-lung machine.
What is Triple Bypass and How is it Performed?
Multiple bypasses are possible with open heart surgery, in which the chest is opened to provide full access to the heart. But the downside of open heart surgery is long recovery, increased risk of infection and other issues. Most patients prefer minimally invasive surgery, if given the option. The least invasive of current options is known as robot-assisted totally endoscopic coronary artery bypass (TECAB).
Until now, technical issues had limited robot-assisted bypass surgery to a maximum of two bypass grafts. But the team has been working to overcome those barriers with improved techniques and new instruments that lift the heart up from the chest to provide access to blocked vessels on the back of the heart. So now surgeons can bypass three vessels, meaning that more patients can benefit from this minimally invasive, robot-assisted heart surgery.
There is a new type of heart-lung machine which is specially designed for use with robotic heart surgery, which is connected to the patient through an artery in the groin. A traditional heart-lung machine requires an opening in the chest.
When the patient is on the heart-lung machine, and the heartbeat is stopped, surgeons can sew extremely tight and accurate sutures with the robotic system. Research indicates that this technique adds to the longevity of the bypass, in contrast to other approaches in which the heart is kept beating.
Advantages of Minimally Invasive Surgery
The minimally invasive procedure eliminates the need for a large incision made down the sternum (breastbone) to access the heart, which reduces a patient's surgical trauma. Other potential patient benefits include:
- Less pain (and need for pain medication)
- Less scarring
- Shorter hospital stay
- Quicker recovery and return to normal activities, and even light sports, within two to three weeks after the intervention.
- Less bleeding and need for blood transfusions
- Lower risk of infection
- The bypass grafts that are used can stay open and supply the heart with blood for a very long time. These so-called internal mammary arteries show durability rates in the 20- to 30-year range and are the best option for a patient with coronary artery disease.
- No foreign material is implanted.
- Except for aspirin, which the patient with coronary artery disease has to take anyway, no blood-thinning medication is necessary.
This page was last updated: July 9, 2013