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How I Do It: Totally Endoscopic Coronary Artery Bypass (tecab) Using The Indigenous Ssi Mantra Robotic System
Lalitaditya Malik, Mch( CTVS).
Manipal Hospital, jaipur, India.
BACKGROUND: Totally Endoscopic Coronary Artery Bypass (TECAB) represents the most advanced evolution of minimally invasive coronary surgery, performed entirely through small ports without sternotomy or rib spreading. Traditionally dependent on imported robotic systems, TECAB in India has been limited by cost and access. The SSI Mantra, India"s first indigenously developed robotic surgical system, offers a significant step toward self-reliant, affordable robotic cardiac surgery.
METHODS: Under general anesthesia with single-lung ventilation, the patient was placed in a 30° right lateral decubitus position. The SSI Mantra system was docked with four robotic ports .The left internal mammary artery (LIMA) was harvested robotically, followed by pericardiotomy and target LAD identification. SSI mantra robot system have a Endo stabiliser ,so with the help of this stabiliser ,beating-heart LIMA-LAD anastomosis was performed endoscopically using 7-0 prolene sutures. The video highlights port positioning, instrument handling, intracorporeal suturing, and specific advantages of the SSI Mantra"s arm design and console control.
RESULTS: The patient was extubated within 6 hours, mobilized early, and discharged on postoperative day 3. CT angiography confirmed excellent graft patency. The SSI Mantra demonstrated stable vision, precise articulation, and smooth workflow throughout the procedure.
CONCLUSIONS: TECAB using the SSI Mantra robotic system is technically feasible, safe, and reproducible. This indigenous platform enables cost-effective, world-class robotic coronary revascularization, paving the way for broader adoption of robotic cardiac surgery in India.
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