What is Minimally Invasive Cardiac Surgery (MICS)?

Over the past decade, minimally invasive cardio thoracic surgery (MICS) has grown in popularity. It is the latest alternative for open heart surgery which is done with the help of special instruments to reduce the size of cut hence also called as ‘Key hole surgery’.

 

What are its benefits over traditional cardiac surgery?

MICS has several advantages over conventional cardiac surgery such as-

  • No bone cutting incision- In convention method surgeon has to approach the heart through middle of the chest cutting through breastbone that’s why it is called open heart surgery. But in MICS surgeon approaches heart from the side of chest through a small hole and operates the instruments from the gap between ribs.

 

  • Smaller scar mark- While in conventional method the size of the opening is 8” to 10”, in MICS it is only 2” to 3”that’s why it is barely visible and cosmetically better.

 

  • Less blood loss- In minimally invasive cardiac surgery there is much less blood loss and patients rarely need blood transfusion after the procedure.

 

  • Lesser Pain and Faster recovery- Since no bone needs to be cut in MICS, the pain is substantially reduced. The patient experiences some pain after surgery because of incision but that alleviates quickly. Same goes for the recovery time. Bones need a lot more time to heal than skin, that’s why patients who undergo conventional surgery take more time to recover.

 

  • Quicker discharge- As compared to conventional surgery which requires the patient to stay for 8-10 day in hospital, minimally invasive cardiac surgery allows the patient to get discharged within 3 to 5 days. Patient can resume daily routine after 2 weeks.

 

  • Lesser chances of infection- Because of smaller incision there are much less chances for the patient to develop surgical site infections during the process of recovery.

 

What procedures can be done with this method?

A wide range of cardiac surgeries can be performed with minimally invasive technique like-

  • Minimally invasive valve repair and replacement-Malfunction of your heart valves can result in backward and inefficient flow of blood. These valves can be repaired or replaced with artificial ones through keyhole surgery.
  • Minimally invasive coronary artery bypass grafting- A person requires CABG when coronary arteries supplying blood to heart muscles gets blocked and angioplasty is not possible. In minimally invasive CABG the blockage is bypassed through another vessel and blood flow is restored.
  • Minimally invasive congenital defect heart surgeries like ASD-Congenital defects like ASD, commonly called as ‘Hole in heart’ can also be treated using minimally invasive techniques.

 

Who is eligible for this surgery?

Possibility of performing heart procedure with this technique depends on many factors like type of problem, its location, patient’s age, other coexisting conditions etc. That’s why everyone is not eligible for it and those people are advised for conventional method. Your doctor will go through your medical history and test reports and let you know the best option, its advantages and risks.

 

What happens in surgery?

Before the procedure, surgeon gets all the information about the patient and checks if the patient is ready for the procedure. During the surgery, surgeon makes an incision of few inches on the side of chest. Size and exact site of incision depends on the procedure. Usually this procedure is performed on beating heart that’s why heart lung machine is not required. After making the incision, surgeon approaches the heart by expanding the spaces between the ribs and performs the procedure using specialized equipments.

 

Life after MICS?

After the surgery patient is kept for observation for 3-5 days, after that he can go home. Doctors help the patient to recover as fast as possible. Patient can start light work like driving car in 2-3 weeks but advised not to do any hard physical work till 4 weeks after the surgery.

After the procedure, patient has to make some lifestyle related changes like-

  • Stop tobacco use
  • Take medication to keep the cholesterol at lower levels
  • Keeping blood pressure and diabetes in control
  • Regular exercise
  • Keeping the weight under control
  • Healthy diet
  • Regular followup with doctor

Limitations of Minimally Invasive Cardiac Surgery-

The biggest limitation is that this surgery cannot be performed on every patient and for every problem. At our hospital we are performing nearly 40% surgeries through minimally invasive method. Furthermore, this surgery also needs special equipment, training and outcome depends on capability of the surgeon.

Future of MICS?

With continuous developments and research in robotic surgery, it will be possible for the surgeons to deliver the benefits of minimally invasive surgery to a wider range of patients with even more precision and safety. Additionally, the recovery of the patient will be more fast and easy.

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