ABSTRACT
The common aim of any minimally invasive surgical procedure is to result in the smallest trauma possible and to perform an intervention by a port-only approach rather than large exposing incisions. Following numerous unsuccessful attempts to undertake endoscopic coronary bypass surgery utilizing long-shafted thoracoscopic instrumentation, the first total endoscopic coronary artery bypass grafting (TECAB) was carried out in 1998 with the aid of a surgical robot. Since then the technique has gradually progressed from a single-vessel to a multi-vessel surgical approach and is performed both on the beating heart and in cardioplegic conditions. TECAB can also be combined with percutaneous coronary intervention (PCI) techniques in what are commonly called integrated or hybrid procedures. Further updated surgical robot generations are available on the medical market and procedure-specific robotic adapters (perhaps better termed “end effectors”) have significantly improved vision, ease of exposure of target vessels, and overall ergonomic features of the operation.
