Minimally invasive surgery is performed by inserting small instruments and a miniature camera into the body through very small incisions. A voice-activated robot may hold a miniature digital camera and light to help surgeons see inside of the patient's body. Recent developments include the use of mini-laparoscopy and micro-instrumentation, which enable ever-smaller surgical entry sites.

This technology is currently being used to conduct a wide range of surgical procedures in general surgery, gynecology and orthopedics.

Traditional Open Heart Surgery versus Minimally Invasive Surgery on a Beating Heart

Coronary artery bypass graft (CABG), or bypass surgery, has been an established technique for the treatment of severe coronary artery disease for more than 20 years. The surgery is done to reroute, or "bypass," blood flow around clogged arteries and improve the supply of blood and oxygen to the heart. Arteries or veins are taken from other parts of the body and connected directly to the coronary arteries on the heart beyond the blockages to create the grafts that channel the needed blood flow.

In "traditional" open-heart bypass surgery, surgeons use the assistance of the cardiopulmonary bypass machine (heart-lung machine) along with medications to stop the heart. Recently, traditional heart surgery has enjoyed a resurgence of attention aimed at reducing trauma to the patient through minimally invasive surgical techniques.

Minimally invasive heart surgery employs smaller incisions directly over target vessels, when possible, and minimizes the use of the heart-lung machine, which may cause postoperative complications. Advanced surgical technology is employed to interfere with the body as little as possible. This means that smaller incisions are used and the patient's heart is not stopped during this procedure.

The minimally invasive approach to bypass surgery offers many advantages to patients over traditional open heart surgery. If the heart is not stopped and the patient is not placed on the heart-lung machine, the risk of stroke or neurological damage is reduced. In addition, because the patient's heart continues beating, there is less risk of blood transfusion, and there is reduced risk that the heart will not start again.

Minimally Invasive Technology for Heart Surgery

The interest of the surgical community and the enormous investment by medical device companies in minimally invasive technology is helping to advance medicine. Minimally invasive techniques have rapidly evolved from "port-access" on a stopped heart to smaller incision beating-heart surgery.

Medical device companies have developed robotic technology to address some of the surgery such as voice activated robots that assist with harvesting the artery used for the bypass. Robots are being developed to assist the surgeon with the rest of the procedure and are currently in clinical trials in Europe and the United States. As these technologies make their way into hospitals, individuals facing traditional heart surgery may look toward minimally invasive procedures as viable alternatives.

Bay Area Heart Institute at San Ramon Regional Medical Center.