Is robotic beating heart totally endoscopic coronary artery bypass feasible for BMI > 35 morbidly obese patients?

Int J Med Robot. 2018 Aug;14(4):e1911. doi: 10.1002/rcs.1911. Epub 2018 Apr 23.


Background: We investigated the outcomes of morbidly obese patients after robotic beating heart totally endoscopic coronary artery bypass (BH-TECAB).

Methods: This is a retrospective single center study. From July 2013 to December 2016, the outcomes of patients undergoing BH-TECAB were reviewed.

Results: A total of 234 patients underwent BH-TECAB (172 male, mean age 65.2 years). There were 43 morbidly obese patients defined as body mass index (BMI) greater than 35, and 191 non-morbidly obese patients. Postoperative complications, or mortality in morbidly obese and other patients were similar except for prolonged ventilation >24 h (11.6% vs 2.1%, P = 0.008).

Conclusions: Morbidly obese patients had an increased incidence of prolonged ventilation after BH-TECAB, but an otherwise reasonably low morbidity and mortality similar to patients with a lower BMI. We believe that adoption of robotics technology allows for BH-TECAB and can lead to improved outcomes in this high-risk population.

MeSH terms

  • Aged
  • Body Mass Index
  • Coronary Artery Bypass, Off-Pump / adverse effects
  • Coronary Artery Bypass, Off-Pump / methods*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / surgery
  • Endoscopy / adverse effects
  • Endoscopy / methods
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Surgery, Computer-Assisted / adverse effects
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome