Minimally Invasive Bypass Surgery in India

Bypass Surgery (CABG)



When the coronary arteries are found to be significantly blocked, the treating doctor manages this by giving the blood a new pathway to reach the heart muscles. During the surgery, blood vessels can be taken from leg (saphenous vein), inside chest (internal mammary artery) or arm (radial artery) and placed around the area or areas of narrowing to "bypass" the blockages and restore blood flow to the heart muscle.

On-pump(Traditional) Bypass Surgery

During surgery by this method, the surgeon makes a cut (about 6 to 8 inches) in the center of sternum/breastbone in order to get direct access to the heart. Patient is connected to a heart- lung bypass machine, which helps in circulation of blood throughout the patient's body during surgery.

The heart is stopped (generally for about 30-90 minutes of the 4-5 hour surgery) and then the cardiac surgeon performs the bypass surgery described above. After the grafting is done and the surgery gets completed, the surgeon then closes the breastbone with special sternal wires and the chest with special internal or traditional external stitches.

Minimally Invasive Heart Bypass Surgery

Recent advances in surgical technique and equipment allow the surgeon to perform coronary artery bypass surgery in a less traumatic way. These types of procedures are called "minimally invasive". Minimally invasive cardiac surgery (MICS) may include a smaller incision, avoidance of the heart-lung machine, or both.

For select patients, the surgeon may decide that minimally invasive bypass surgery is appropriate. MICS (minimally invasive cardiac surgery) procedures are often done on a beating heart or through a smaller incision. Pioneering work is also being done throughout the world to develop techniques that will allow surgeons to perform beating-heart bypass procedures through "keyhole" incisions.

Unlike conventional surgery, which has a 10"-12" incision and places the patient on the heart-lung machine, new minimally invasive approaches may avoid placing the patient on a heart-lung machine, and can be performed through a 3"-5" incision placed between the ribs, or may be done with several small incisions. "Keyhole" or "endoscopic" bypass procedures, which are still in development, are performed through small incisions measuring 1"-2" wide.

Following are some of the advantages of minimally invasive bypass surgery :

• Less Bleeding and thus lesser blood transfusion.
• Lower risk of infection
• Minimum pain and trauma
• Faster recovery time
• Shorter hospital stay - 3 days in most cases, instead of 7 to 8 days of stay in surgery by traditional method.
• Smaller scar due to small incision.

Robotically Assisted Heart Surgery in India

This technique, also known as closed heart surgery, is a type of minimally invasive surgery. Here, the cardiac surgeon uses a specially designed computer console to direct surgical instruments on thin robotic arms. Robotically assisted technology lets surgeons to perform certain types of intricate heart surgeries with smaller incisions and accurate motion control, offering patients excellent results. In robotic surgery, very small incisions-less than 2 inches-are done, compared with the 3- to 4- inch incision used in traditional minimally invasive heart surgery. The advent of this technique has revolutionized the concept of heart surgery as it makes the surgery easier to perform. 

Kindly note that not every patient is a candidate for these surgical techniques. The surgeon reviews the results of diagnostic tests before scheduling surgery to determine if patient is a candidate for minimally invasive surgery. The surgical team very carefully compares the advantages and disadvantages of minimally invasive techniques versus traditional surgery techniques and then decides which one is to be specifically used for the patient.


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