Traditionally heart surgery was performed through a big cut in the middle of the chest and opening the breast bone (sternotomy). This gives the best access to the heart and allows performing all types of heart surgery. The downside is that breast bone needs around 3 months to completely heal, which will restrict some activates such as lifting and pushing.
Minimally invasive endoscopic heart surgery (MIS) has improved significantly over the last few years and many heart operations can be done through smaller cuts with similar level of efficiency and safety. MIS is performed through much smaller cuts either in the middle of the chest or on the side. It usually involves a small cut in the groin for the heart and lung machine.
Benefits:
MIS offers some advantages to the patient, while offering same good quality operations and those include:
- Less pain and discomfort
- Shorter hospital stay
- Quicker recovery and return to work, driving and lifting weights
- Better cosmesis and hidden scars
Limitations
However, it is important to note that only a number heart operations is possible through the minimal approach, and most of heart surgery operations are still done through the conventional open way. In addition, not every patient is suitable for the endoscopic approach.
No compromise
The desire for performing minimal access surgery should NOT compromise the main the operation, eg. Not preforming full revascularisation or suboptimal valve repair. Conventional open cardiac surgery is perfectly acceptable. It should not be undervalued. It offers excellent outcomes, and even if it takes longer to heal, it still offers very good long term outcome.
Team Work
Minimally invasive operations are demanding and require synchronized team work. It should be performed with good preoperative planning in experienced centres.