Surgical Procedures

Currently, NYPH/Columbia surgeons employ two robotic approaches to coronary artery bypass surgery. In robotic minithoraCAB, the robot assists with the procedure, while the TECAB approach is completely robotic.

Robotic MiniThoraCAB

Robotic MiniThoraCAB, or robotically-assisted, minimally invasive, off-pump coronary artery bypass graft, allows the surgeon to perform a single or double bypass for coronary artery disease without a sternotomy (full incision of the breastbone) or the use of the heart-lung machine. The left and/or right internal mammary artery, which is used to bypass the blocked arteries, is removed through three 1 cm puncture wounds in the left chest. An off-pump coronary bypass is then performed through a 2 inch left minithoracotomy, using special retractors and stabilizers developed at Columbia.

(Left) Off-pump coronary bypass surgery performed through a two-inch left minithoracotomy, using the "A-rod," a cardiac stabilizer developed at Columbia. (Right) Postoperative photo taken two weeks after an off-pump double bypass via minithoracotomy.

TECAB (totally endoscopic coronary artery bypass grafting)

The nation's first robotically-assisted, totally endoscopic coronary artery bypass surgery (TECAB) was performed at Columbia on January 15, 2002. During this historic operation, three tiny holes between the ribs permitted two robotic arms and an endoscope to access the heart. Drs. Argenziano and Smith performed the procedure as part of a multicenter clinical trial sanctioned by the FDA. Dr. Argenziano was the principal investigator on the 10-center trial, which was the first in the nation for totally closed chest coronary bypass surgery. At Columbia, TECAB patients have experienced minimal postoperative pain and returned to normal activities within a few weeks after surgery. The FDA has since approved use of the da Vinci® Robotic Surgical System for coronary artery bypass surgery.

After undergoing TECAB, the patient (above left) was home within three days and back to full activity within a week of surgery. His three-month postoperative angiogram (shown) demonstrates a fully successful graft.