Minimally invasive surgery is no longer exotic. As surgical techniques improve, more and more minimally invasive procedures can be done with the same outcomes as conventional “open” surgery, with fewer complications and a quicker recovery.
Since the world’s first minimally invasive mitral valve procedure was performed at Cleveland Clinic 13 years ago, minimally invasive options are now the first considered for nearly every patient.
Here’s a quick look at 6 procedures you might not have known can be done minimally invasively:
1) Mitral Valve Replacement and Repair – The most frequently performed minimally invasive surgery is mitral valve repair. Your mitral valve is one of four heart valves, which lies between the left atrium (upper heart chamber) and the left ventricle (lower heart chamber). Cleveland Clinic cardiac surgeons A. Marc Gillinov, MD, and Tomislav Mihaljevic, MD, who share a great deal of experience in all minimally invasive procedures, say it’s possible to both repair and replace valves minimally invasively. However, they recommend repairs in most cases, as repairs result in better long-term outcomes. More minimally invasive mitral valve repairs are performed at Cleveland Clinic than at any other medical center.
2) Robotically Assisted Mitral Valve Repair – Robotically assisted mitral valve surgery is a type of minimally invasive surgery in which the surgeon uses a specially designed computer console to control surgical instruments on thin robotic arms. The surgeon uses the robotic arms to perform the robotic surgery through 1- to 2-inch incisions in the right side of the chest. This approach lets surgeons perform complex repairs without dividing the breastbone and spreading the ribs.
3) Coronary Artery Bypass Graft Surgery – Coronary artery bypass surgery, known as CABG, or “cabbage,” uses blood vessels to “bypass” a blockage and restore blood flow to the heart. The traditional “open” procedure was pioneered at Cleveland Clinic in 1967 and is performed every day at academic medical centers and community hospitals alike. But recently, surgeons have been successfully performing this operation through a smaller incision and – in some cases – without the use of a heart-lung machine. Joseph F. Sabik, MD, Chairman of Thoracic and Cardiovascular Surgery, is now performing a “mini” CABG through 3- to 4-inch incisions. The “mini” method means less pain and a shorter recovery, including a hospital stay that’s shorter by about two days. In addition, the surgery doesn’t require dividing the breastbone and is most often done without a blood transfusion.
4) Percutaneous Procedures – Some cardiac procedures that are usually done openly or minimally invasively can now also be done percutaneously. Percutaneous (also called endovascular) procedures use special catheters and devices to treat the problem through one or more small puncture sites through the skin and a thin video instrument with a small camera at the tip. This scope transmits a picture of the internal organs on a video monitor to give the surgeon a close-up view of the surgical area as he performs the procedure. For the patient, percutaneous procedures mean very small incisions and a much quicker recovery time. Even better, they may offer options for some patients who could not undergo conventional surgery due to poor heart function or additional medical problems. A number of percutaneous procedures are part of everyday practice while others are still being evaluated in research studies.
5) Video-assisted Thorascopic Lobectomy – Cleveland Clinic thoracic surgeons offer a less invasive surgical approach, called a video-assisted lobectomy, for select patients as treatment of early-stage lung cancer. This video-assisted thoracic surgery (VATS) technique reduces a patient’s hospital stay to about three to four days and the patient experiences a more rapid recovery with less pain after VATS lobectomy surgery as compared with the traditional thoracotomy approach. Cleveland Clinic is one of the few centers in the nation with significant experience in VATS lobectomy. In addition, the surgical outcomes of VATS lobectomy are comparable to traditional lobectomy outcomes.
6) Minimally Invasive Vein Harvesting – Before performing bypass surgery, heart surgeons determine what type of blood vessels are needed to create the bypass graft. They may use the artery in your chest (mammary or thoracic artery), the artery in your arm (radial artery) or the veins in your legs (saphenous veins). In the past, obtaining the saphenous vein or radial artery required a long incision. Now, minimally invasive (endoscopic) approaches to harvesting saphenous veins and radial arteries allow for a better overall patient experience after coronary artery bypass surgery. Because the incisions are tiny, endoscopic procedures cause little blood loss and the risk of infection is small. These techniques reduce patient discomfort, minimize scarring and shorten recovery time.
For more information:
If you need more information, click here to contact us , chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
Know someone who could use this information? Send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
© Copyright 2009 Cleveland Clinic. All rights reserved. 5/09
