**8. Conclusion**

At first, the TECAB technique was limited to treating single vessel disease with LITA-LAD anastomosis on an arrested heart with CPB support and in time it is proven to be safe and feasible [50, 51]. Since robotic surgical technology continues its exponential growth, the advancements in the next generations of the da Vinci robotic systems will be expected to enhance treatment options even for the highrisk patients with multivessel disease.

Robotic-assisted, totally endoscopic, off-pump CABG has been shown to be safe and feasible in treating the multivessel disease and offers outstanding results in experienced hands. To achieve successful results, the whole surgical team should master robotic surgery, and be in harmony during the procedure and in the meantime, the highest attention should be directed to the hemodynamic and hemostatic parameters of the patient.

However, the surgeons should note that robotic-assisted CABG surgery has a steep learning curve and should start with gaining experience in the treatment of single-vessel cases before progressing to multivessel procedures. Intensive training on hand-sewn suturing techniques using dry and wet-lab models is essential and highly recommended. Due to the steep learning curve and the lack of excellence centers focused on the robotic-assisted CABG, the interest from the industry has been half-hearted.

Finally, since robotic surgical technology is experiencing exponential growth and expanding its use in many specialties, it is of vital importance for us, the surgeons, to be a part of these advancements and train the next generation of surgeons accordingly in order to help them serve our society with latest minimally invasive approaches.
