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3 . 2026

Comparison of outcomes between robot-assisted coronary artery bypass grafting and MIDCAB/MICS-CABG

Abstract

Background. Minimally invasive coronary artery bypass grafting (MIDCAB/MICS-CABG) techniques have gained wide acceptance in modern medicine. The number of robotic-assisted operations increases annually, with more and more surgeons mastering minimally invasive techniques.

Objective. To analyze the outcomes and evaluate the technical advantages of robotic-assisted coronary artery bypass grafting (RACAB) technique compared to minimally invasive techniques (MIDCAB/MICS-CABG).

Patients and methods. In the Department of Minimally Invasive and Robotic Cardiovascular Surgery Cardiovascular Surgery at University Clinical Hospital № 1, 80 coronary artery bypass grafting procedures utilizing minimally invasive techniques were performed: 40 patients underwent MIDCAB/MICS-CABG, and 40 patients underwent robotic-assisted surgery. The two groups were comparable in terms of baseline demographic and preoperative clinical characteristics. A comprehensive assessment of intraoperative parameters, early postoperative outcomes, and patient status during the first 30 days after surgery was conducted.

Results. All surgical procedures were completed by a single surgical team using the da Vinci Si robotic system. In both groups, there were no cases of hospital mortality, conversion to sternotomy, acute cerebrovascular accidents, acute renal failure, or clinically significant postoperative bleeding. The robotic-assisted coronary artery bypass group demonstrated statistically significantly lower intraoperative and postoperative (POD day 1) blood loss (p<0.05). Pain intensity in the early postoperative period was also significantly lower in the RACAB group (p<0.001). The length of hospital stay was significantly shorter in the RACAB group, amounting to 10 [9, 14] days compared to 14 [13, 21] days in the MIDCAB/MICS-CABG group (p<0.001). However, the duration of surgery was statistically significantly longer for robotic-assisted coronary artery bypass – 299±70 minutes versus 256±69 minutes for MIDCAB/MICS-CABG (p=0.007).

Conclusion. Robotic-assisted cardiac surgery not only is non-inferior to standard minimally invasive approaches but also demonstrates superior outcomes across several key parameters.

Keywords:coronary artery bypass grafting; minimally invasive cardiac surgery; robotic surgery; RACAB; MIDCAB; MICS-CABG

Authors’ contribution. Study conception and design – Komarov R.N., Lutsenko I.V., Ognev O.O.; data collection and handling – Lutsenko I.V., Chernyavsky S.V., Kasim T.Kh.; draft manuscript preparation – Lutsenko I.V., Kazban N.E., Al Atrach M., Romanovskii A.A.; manuscript revision – Lutsenko I.V., Ognev O.O., Kazban N.E., Al Atrach M., Romanovskii A.A.

For citation: Komarov R.N., Lutsenko I.V., Chernyavsky S.V., Ognev O.O., Kasim T.Kh., Al Atrach M., Kazban N.E., Romanovskii A.A. Comparison of outcomes between robot-assisted coronary artery bypass grafting and MIDCAB/MICS-CABG. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (3): 56–63. DOI: https://doi.org/10.33029/1027-6661-2026-32-3-56-63

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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