What Is Minimally Invasive Cardiac Surgery?

Minimally invasive cardiac surgery is a long awaited dream of many a surgeon and consumer. Why?

Minimally invasive cardiac surgery is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach (splitting the breast bone.)

Minimally invasive heart surgery (also called keyhole surgery) is performed through small incisions, sometimes using specialized surgical instruments. The incision used for minimally invasive heart surgery is about 3 to 4 inches instead of the 6- to 8-inch incision required for traditional surgery.

Minimally invasive and robotic operations use a series of smaller incisions placed between the ribs. Surgical instruments and a camera are placed through these incisions and the surgeon views the operative field on a monitor. Since the breastbone remains intact, minimally invasive and robotic procedures typically reduce postoperative pain and require less recovery time.

The surgical view is that surgery on the heart must be done “properly”, i.e. under good vision and have the ability of the surgeon to quickly fix things if complications occur. Indeed, if things go wrong, the likely outcome of complications can be devastating and deadly. So, there has been a psychological safety barrier that needs to be overcome by the practicing cardiac surgeon to embrace this philosophy of using minimally invasion.

The consumer or patient’s view is that smaller incisions, especially “robotic” or “keyhole” are so much better than conventional large incision surgery.

 


 Dr. Jai Raman has the largest experience in the Chicago region with minimally invasive cardiac surgery.


 

The truth lies somewhere in between. Historically, cardiac surgery developed as an off-shoot of thoracic surgery and the early pioneers were all technically excellent surgeons who were used to working against the clock. These surgeons liked to get their hands in, fix the problem and get out.

The sternotomy was developed and popularized by Julian in the late 1950s and proved be a very utilitarian incision, providing access to all chambers of the heart. This incision, though destructive in concept (because of the cutting of the sternum), was easy to replicate and allowed good access and visualization.

The closure of the sternum by wires at the end of the cardiac procedure was the adaptation of standard wire circlage of bone that was prevalent at the time.

This website seeks to promote the advances in cardiac and thoracic surgery with a minimally invasive focus. Our aim is to provide the reader access to the well developed and developing areas of research in this arena. We will also have information on how closure of some of these incisions can be achieved with less discomfort, how plate closure of the bones in the chest may dramatically reduce complications and pain, and explore future horizons in the heart.

So, welcome and hope you keep asking questions and find what you need.