UW Health Adds Coronary Artery Bypass Graft (CABG) to Robotic Surgery Options
UW Health Services
UW Health cardiovascular surgeons Lucian Lozonschi, MD, and Takushi Kohmoto, MD, began by performing robotic CABG on patients with damage to the left anterior descending coronary artery, what surgeons refer to as the "widowmaker" vessel. Recently, Dr. Lozonschi partnered with Mark Sasse, MD, a UW Health interventional cardiologist, to begin operating on patients whose bypass problems can be treated with a hybrid procedure that combines stents and robotic CABG surgery. UW Hospital is one of only a handful of centers nationwide that offers this type of procedure.
"Instead of receiving a breast bone-splitting procedure, these patients are getting the advantage of one of the best surgical improvements of the last decade," says Dr. Lozonschi, who has been performing robotic CABG surgeries since December. "From a pulmonary perspective, this is significant advantage for our more elderly patients."
As with other robotic surgeries, the biggest benefit to patients is the minimally invasive nature of the procedure. Surgeons need create only three pen-sized holes in the patient's skin in addition to a small sub-mammary incision to perform a procedure that typically requires opening the patient’s sternum.
That benefit also extends to some patients with three-vessel coronary artery disease who qualify for a hybrid approach and who would normally be treated with either CABG through a median sternotomy or stents only. The hybrid approach combines the advantages of both procedures. Dr. Sasse believes this group includes older patients whose aortas have become calcified ("porcelain aorta") and those who may need to recover and return to work quickly. Recovery from robotic CABG and the hybrid procedure typically takes a few days. Recovery from standard, open-chest bypass can take months.
"For people who are limited in their ability to take time off work, and those who have to lift or work with heavy equipment, this is an excellent option for them," says Dr. Sasse, who performed the first hybrid procedure at UW Hospital in January. "However, someone who sits at a desk all day may fare better with a regular open CABG procedure."
Dr. Sasse typically places stents in no more than two vessels per patient, choosing vessels out of range of the robotic-assisted procedure. In some cases, the stenting can be done a few hours following bypass surgery. In others, the patient may be discharged and return days or weeks later to receive the stents.
UW Hospital has been using the Da Vinci surgical robot since early 2006. Surgeons currently use it to perform a host of complex surgeries, including prostatectomies, hysterectomies and other complex cardiothoracic procedures.
For more information about CABG at UW Health, call (608) 263-1530.