Did you read what I posted???
did
you read the study i linked? these are discussed.
likewise, this are not different vessels. this is not a different procedure, per se. the same lima is still divided and re-anastomosed in a similar fashion as an open bypass. we are not talking about a different patient population either.
why would you think that there would be a different long-term prognosis, graft secondary occlusion, or re-operation rate in the same patient population? the study i linked (and there are a lot of others) already account for this. now, if those studies showed that a disproportionately high number of patients had to convert to standard sternotomy, then i would think this procedure is crap. but, my inclination is to believe - and is
backed by the data - that you are
less likely to have peri-operative complications (eg, infections, pain, bleeding, etc.) with a minimally-invasive technique than an open one. as far as long-term complications (eg, re-occlusion, secondary surgeries, etc.), there is
no reason to believe that cohorts would be different.
what is yet to be proven is whether additional cost and op time, as well as investment in the equipment and surgeon training, is substantianal enough to justify this technique over the long-term. but, i imagine that as the davinci becomes more accepted, widely available, and adopted and incorporated by training programs, you're going to see a lot more of this procedure done. it's clearly already proven
far superior in, for example, radical prostatectomy.
the rest of your speculations are just that, and have already been studied and have disproven in this and other studies. it has been shown already to be beneficial to this patient population in capable surgical hands. in the meantime, you are reminding me of a reactionary who'd argue back in the day that open cholecystectomy was still superior to lap chole, simply because (perhaps) you are resistant to change.
