Robotic-assisted CABG safe, reduced patient recovery time

Robotic-assisted CABG was a safe, feasible alternative to surgical revascularization and associated with shortened hospital stay and recovery time, according to results presented at the Canadian Cardiovascular Congress.

Richard C. Cook, MD, MSc, from the University of British Columbia, reported recent experience from three Canadian institutions with minimally invasive robotic-assisted CABG. All procedures incorporated the da Vinci Surgical System, which provides the surgeon with a high-definition 3-D image of the patient’s body. The surgeon operates controls while robotic arms mimic the movements of their hands, wrists and fingers to perform the procedure. Harvesting of internal thoracic arteries was performed with robotic assistance, and anastomoses were constructed manually with an anterior, non–rib-spreading incision or closed-chest with robotic assistance, without cardiopulmonary bypass.

The cohort included 300 patients (mean age, 60 years) with significant disease involving the left anterior descending artery.

According to results presented, no perioperative deaths occurred. Four patients required re-exploration for bleeding. One patient developed a deep-wound infection after surgery.

During follow-up, re-intervention in the left anterior descending artery was required for six patients, including four repeat surgeries and two percutaneous stentings, due to recurring angina/ischemia. Poor flow from the conduit after robotically assisted artery harvesting occurred in three patients.

The researchers noted a 98.7% patency rate among patients who had intraoperative angiography.

The median ICU stay was approximately 1 day and median postoperative hospitalization was approximately 4 days. Patients reported returning to near-normal activity levels with 2 weeks after the procedure, according to a press release.

“Robotic-assisted CABG is a safe and feasible alternative approach to standard bypass surgery in properly selected patients,” Cook said in the release. “It is a less traumatic and less invasive approach than regular CABG. It may reduce complications following surgery, and in the Canadian experience, has been associated with an extremely low mortality rate.”

For more information:

Cook RC. Abstract #208. Presented at: Canadian Cardiovascular Congress; Oct. 25-28, 2014; Vancouver, British Columbia.

Disclosure: Cook reports no relevant financial disclosures.