Minimally Invasive Treatment of Coronary Artery Disease with TECAB
What is Coronary Artery Disease?
- Coronary artery disease is the most common heart disease and is the number one killer of adults in the United States.
- The disease is a condition where plaque builds up inside the coronary arteries, reducing the amount of blood flow to the heart muscles and possibly increasing the risk of a blood clot to form. When this happens, the person suffers a heart attack.
- The most effective treatment is bypass surgery, where a piece of blood vessel from another part of the body is harvested for the surgeon to make a bypass around the narrowed coronary artery so that oxygenated blood can make it to the heart.
- The standard operation required that the chest be opened to access the heart - requiring splitting the breastbone (sternum) and an extended recovery period - until the advent of the TECAB.
About Beating-heart Totally EndoscopicCoronary Artery Bypass (TECAB)
- Beating-heart Totally Endoscopic Coronary Artery Bypass (TECAB) Surgery is performed in a totally closed-chest setting with robotic assistance, without major incisions and without splitting the breastbone.
- This means faster recovery and a lower risk to patients because the procedure is conducted without a heart-lung machine, which reduces the risks for neurological complications and stroke.
- All patients are suitable for TECAB whether they are young, middle-aged or older. The procedure is ideal for obese patients since surgery is less invasive.
How TECAB is Done
- The surgeon uses the da Vinci’s remote-controlled robotic arms to perform the procedure, making small incisions in the side of the chest without cutting open the chest.
- Ports are used to pass materials into the chest like a video camera and two or three additional robotic instruments.
- The robot's "wristed" instruments provide a greater range ofmotion (pivot 540 degrees) than the human hand and eliminates physician tremor.
- The surgeon looks through a 3-D videoscopic binocular from a console yards away from the OR table, and uses joysticks and foot pedals to operate the robotic system.
- The internal mammary artery is prepared by clamping it and partially cutting it.
- U-clips are then placed in the artery. The bypass vessels are prepared inside the chest and no cutting of the leg or arms is necessary.
- The coronary artery is temporarily closed so that the mammary artery can be sewn to it, and a new bypass is created with obstructions released.
- Once the bypass grafts have been placed, the surgeon and his team check the quality of the grafts via an angiographic exam.
Potential Patient Benefits
- After the operation, the patient is transported to an intensive care unit for observation. The patient will be on a ventilator for several hours.
- Patients can drink, eat and walk around very quickly and are discharged home usually within four to five days after the operation.
- The results of TECAB are minimal surgical trauma and scarring for the patient like less bleeding and no spreading of ribs, which results in less pain.
- Patients can resume everyday activities two to three weeks after discharge from the hospital.
- The procedure also has a lower risk of infection and no foreign material is implanted.
- It eliminates the need for a large (6-10 inch) incision made down the sternum (breastbone).
- The internal mammary arteries show durability rates in the 20- to 30-year range.
- Except for aspirin, no blood-thinning medication is necessary.
For more information about robotic surgery, call 1-866-250-STJO or click here.
Revascularization Surgery
