Learn about High-Precision Robotic Surgery Without any Opening of the Chest at the University of Maryland Medical Center. From the site:

Totally endoscopic coronary artery bypass (TECAB) is the least invasive coronary artery bypass grafting operation. The bypass graft is placed through tiny holes without any opening of the chest. In comparison to coronary artery bypass grafting procedures, which are carried out through very small openings in the chest — mini-thoracotomies — (MIDCAB, SVST), the operation is performed only through these small portholes. As a result, the surgical trauma and scarring for the patient are very minimal.

The surgeon uses a surgical robot (da Vinci system) for the procedure, which enables the surgeon to perform complex surgical maneuvers inside the chest. The surgeon inserts a video camera, which is mounted on the operation robot, into the chest and uses two or three additional instruments on the robotic arms….

…The bypass vessels are prepared inside the chest and no cutting of the leg or arms is necessary. A very small incision is made in the groin for connection of the heart-lung machine. A sophisticated special heart-lung machine system is used for these operations. This system serves as a safety net for the patient and takes over the blood circulation while the heart is stopped for the bypass graft connection. The surgeon is working on vessels that are approximately 2 to 3 millimeters in diameter. A stopped heart and the robotic system ensure very accurate suturing of tiny bypass grafts.

After the bypass grafts have been placed and the heart-lung machine is removed, the surgeon and his team check the quality of the grafts by an angiographic exam, which is done while the patient is still under general anesthesia.

A video of Dr. Johannes Bonatti performing the surgery can be found here.

More sites that perform this surgery can be found here.