Totally endoscopic coronary artery bypass grafting is feasible in morbidly obese patients.

Development of robotic technology has enabled totally endoscopic coronary artery bypass grafting (TECAB) procedures. With complete preservation of sternal and thoracic stability, this operation would be an interesting option for obese patients, who are known to be at higher risk for deep sternal wound infection. We describe a case of successful totally endoscopic left internal mammary artery to left anterior descending artery bypass grafting using the da Vinci telemanipulation system in a patient who was morbidly obese. The patient underwent a so called staged hybrid coronary intervention with percutaneous angioplasty and placement of a stent to the right coronary artery.