Despite the advantages of CABG, the number of procedures has been under pressure
with the growing popularity of stents as patients increasingly seek less invasive
solutions. Innovations aimed at making the surgical procedure less invasive include
beating heart or off-pump CABG, limited access techniques, endoscopic vessel harvesting
and key hole surgery using master-slave robots. To date, however, these developments
have failed to integrate into a reproducible minimal invasive procedure, suitable
for mainstream adoption. The limiting factor is the surgical difficulty of suturing
the anastomoses reliably without fully conditioning the environment to accommodate
the surgeon's needs. Automated anastomotic technology could address these difficulties,
and eventually enable total endoscopic, off-pump CABG, moving surgery closer to catheter
based procedures. In certain cases, combining PCI and CABG in a hybrid procedure
may offer patients the best of both worlds.
