A new exposure technique for the circumflex coronary artery system in robotic totally endoscopic coronary artery bypass grafting

Abstract
We report a case of a 53-year-old female patient with isolated left main coronary artery stenosis in whom a completely endoscopic double coronary artery bypass grafting (CABG) procedure was performed. The operation was carried out on the arrested heart. A right internal mammary artery graft was sutured to the left anterior descending artery using the daVinci telemanipulation system. The left internal mammary artery was connected to the first obtuse marginal branch which was exposed with the Octopus-TE stabilizing device. This method may be useful for further development of multivessel totally endoscopic CABG procedures.