{
  "abstract": "Background Coronary artery bypass grafting (CABG) is a surgical procedure that uses the internal mammary arteries, as shown in image 1, to overcome blocked coronary arteries. Robotic coronary artery bypass grafting (RCABG) has emerged as an innovative alternative to traditional CABG, offering potential advantages in precision, reduced invasiveness, and patient recovery. Despite these technological advancements, adoption remains limited, and surgical outcomes compared to conventional approaches remain under debate.Methods A focused literature review was conducted using PubMed/MEDLINE, the Cochrane library, Scopus, and ClinicalTrials.gov to identify recent studies evaluating robotic coronary artery bypass grafting (CABG) in comparison with conventional CABG and other established revascularization strategies. The literature search was conducted in February 2020 and updated in October 2020 to incorporate newly published data.The following search string was used (with database-specific adaptations):(‘robotic coronary artery bypass’ OR ‘robot-assisted CABG’ OR ‘totally endoscopic coronary artery bypass’ OR ‘TECAB’ OR ‘minimally invasive coronary revascularization’)AND(‘coronary artery bypass’ OR ‘CABG’ OR ‘conventional CABG’ OR ‘traditional coronary artery bypass’)Eligible studies included systematic reviews, meta-analyses, randomized and non-randomized comparative studies, observational cohorts, and high-impact narrative reviews addressing robotic CABG, hybrid coronary revascularization, or minimally invasive surgical approaches. Articles published in languages other than English and those older than five years were excluded.Findings This review synthesises the current literature on robotic coronary artery bypass, including totally endoscopic approaches and other minimally invasive techniques. Robotic assistance avoids a sternotomy, resulting in less postoperative pain and tissue trauma, making it particularly advantageous for patients at higher risk of wound complications, including smokers, obese individuals, older adults, and those with chronic kidney disease. Technical benefits include improved visualisation through three-dimensional magnification, enhanced lighting, greater instrument dexterity, and ergonomic comfort for the surgeon. Robotic techniques facilitate full-length internal mammary artery harvesting, making bilateral internal mammary artery grafting more feasible, which may improve long-term outcomes. Hybrid procedures combining surgical and percutaneous interventions show promise, though standardised protocols are lacking and outcomes remain variable. Robotic totally endoscopic procedures exhibit a steep learning curve, but conversion rates have markedly decreased overtime with increased surgical experience, as shown in image 2. Recent systematic reviews indicate that robotic procedures are associated with reduced postoperative complications, shorter intensive care and hospital stays, and favourable graft patency, while ongoing innovations continue to expand indications and improve procedural safety. Limitations include high initial system costs, procedural complexity, and the need for specialised training.Conclusions RCABG represents a significant advancement in coronary revascularisation, with the potential to improve patient outcomes when performed by experienced surgical teams. Further studies and technological refinements are required to overcome current barriers and optimise clinical adoption. This review provides an accessible overview suitable for both aspiring cardiac surgeons and experienced clinicians interested in robotic CABG innovations.Abstract 243 Figure 1Both internal mammary arteries in their anatomical positions near the coronary arteries of the heartAbstract 243 Figure 2Decline in TECAB conversion rates over time, demonstrating the progressive improvement in procedural proficiency from early reports (~50%) to 11.5% in 2019 and below 3.2% in 2024",
  "authors": [
    {
      "affiliations": [
        "Northumbria University, Newcastle Upon Tyne, United Kingdom",
        "St. George’s University School of Medicine, True Blue, Grenada"
      ],
      "name": "Hussien Abouzeid"
    },
    {
      "affiliations": [
        "Northumbria University, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Nermine Beshara"
    },
    {
      "affiliations": [
        "Northumbria University, Newcastle Upon Tyne, United Kingdom"
      ],
      "name": "Mustafa Abrar Zaman"
    }
  ],
  "title": "243 Robotic advances in coronary artery bypass grafting: a literature review",
  "uid": "300045ca-1a91-58b9-bd03-be9fd9046bd2"
}