Minimally Invasive Bypass Surgery

Now, without any delay, let’s understand the meaning of Minimally Invasive Bypass Surgery.

Minimally invasive heart surgery is a term for heart procedures performed through one or more small cuts (incisions). During invasive coronary artery bypass procedure, surgeons insert small, high-powered cameras, tools or robotic arms through the incisions. The surgeon guides the tools between the ribs in order to access the heart. Unlike open heart surgery, minimally invasive cardiac surgery is less painful and the recovery is shorter. It is a lifesaving option for high-risk patients who are facing certain medical conditions.

Types of Minimally Invasive Bypass Surgery:

There are several types of minimally invasive bypass surgery. Let’s have a look at them one by one:

• Mitral Valve Repair Surgery: It is used to repair a mitral valve that isn’t working properly due to valvular heart disease. Mitral valves can be treated through Annuloplasty and Commissurotomy. During Annuloplasty surgery, an abnormal section of the valve is removed, edges are sutured back together and then a cloth-covered ring is placed around the valve. During Commissurotomy surgery, mitral valves are surgically separated to relieve stenosis.
• Aortic Valve Replacement: During this procedure, a large cut (incision) of about 25 cm long is made in your chest to access the heart. Once your heart gets stopped, the machine takes over the job of your heart during operation. Finally, the faulty valve is removed and replaced with new one, the heart gets restarted once again.
• Coronary Artery Bypass Grafting: Coronary artery disease (CAD) is the most common type of heart disease. During this surgery, the coronary arteries get narrowed due to buildup of fatty material with the walls of the arteries, the supply of oxygen-rich blood to the heart muscle gets stopped. With this surgery, the blood vessels or grafts are grafted above and below the blocked area of a coronary artery. This allows blood to flow around the obstruction.
• Left Ventricular Assist Device (LVAD): It’s a kind of a pump that is used for the patients who have reached end-stage heart failure. During this surgery, a battery-operated mechanical pump is implanted which then helps the left ventricle pump blood to the rest of the body.
• Atrial Septal Defect Repair: An atrial septal defect (ASD) is a congenital heart defect. With this defect, the muscular wall separates the two upper chambers (atria) of the heart. Small ASDs usually don’t need treatment. However, the larger ones may require minimally invasive surgery to lower the risk of serious complications.
• Tricuspid Valve Replacement Surgery: During tricuspid valve replacement surgery, a surgeon removes the diseased valve. Then, it replaces with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).

What does a minimally invasive bypass surgery procedure involve?

Minimally invasive bypass surgery procedures (using small incisions) include laparoscopic surgery that reduces the damage to human tissue. The surgery includes small “ports” from which surgeon inserts thin tubes, known as trocars. Carbon dioxide is used to inflate the area, that helps create the open heart surgery space between the internal organs and the skin. Further, a miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars. This allows the surgical team to view the procedure as a magnified image on video monitors in the operating room. This kind of surgery provides equivalent outcomes as in traditional surgery, but with significant benefits like – faster recovery, less pain, one can leave the hospital in lesser days etc.

Let’s understand its benefits in detail:

1. Less Pain: As involves a large incision; the chances of discomforts are high. However, with minimally invasive heart surgery, patients experience much pain following the procedure.
2. Less scarring: You can expect to have a large scar in the middle of your chest after healing from open heart surgery. With minimally invasive heart surgery, on the other hand, patients have much less scarring and have an improved cosmetic result.
3. Faster recovery: Minimally invasive heart surgery allows patients to start their regular activities and get back to the work as soon as possible.
4. Shorter stay in hospital: People who undergo minimally invasive heart surgery returns home within 2 to 5 days of surgery. Whereas, patients who opt for open heart surgery typically takes 8-10 days.
5. Minimal complications: Chances of experiencing complications are lower with minimally invasive
   heart surgery. But, with open heart surgery, patients may experience risk of infection and bleeding.
6. Decreased blood loss: Minimally invasive bypass surgery doesn’t lead to much blood loss. Whereas, in open heart surgery, the volume of blood drained after the operation is quite higher.
7. Other benefits include better survival rate, lower risk of depression and fewer complications in the kidney or liver.

How minimally invasive bypass surgery is different from open heart bypass surgery?

Heart surgery is done on the heart muscles, heart arteries, heart valves and other arteries connected to the heart. The term “open heart surgery” means that you get connected to a heart lung machine, or bypass pump during surgery. Whereas, minimally invasive bypass surgery is a robot assisted surgery during which several small incisions (less than a half-inch) between the ribs are created. Then, instruments are inserted through the incision into the chest cavity. Then, the surgeon sits at a console to control the robotic arms that help move the instruments to perform the procedure.

Why might a person need Minimally Invasive Bypass Surgery?

Your healthcare provider may recommend a minimally invasive bypass surgery when you have a blockage in one or two arteries, mostly in the front of the heart and the heart doesn’t get enough blood. Also, some patients prefer this kind of surgery in order to lower the risk of infection, spend a shorter time in the hospital and get back to normal activities quickly.

How long does the surgery take?

The procedure takes about two to six hours. After surgery, you will typically spend 1 or 2 days in the ICU. You may have drainage tubes in the chest to prevent fluid buildup around your heart. It is normal to feel tired, have shortness of breath and have pain in the chest area around the wound. Your surgical team will help you get up and walk just within one or two days of surgery. During the first six weeks of post-surgery, most patients would need to restrict certain activities that will be determined by the surgeon, based on their overall health and recovery process.

Minimally invasive bypass surgery cost

The minimum cost of minimally invasive cardiovascular surgery (MICS) in India starts from Rs. 2,35,000 and goes upto Rs. 5,00,000 depending upon your medical history and condition.

Factors affecting Minimally Invasive Bypass Surgery cost in India:

(a) Cardiac Surgeon’s Fees: The charges for this kind of surgery totally depend upon the experience and skills of the surgeon. It is really important to approach surgeons who have a proven track record of delivering successful surgeries so that you would completely be in safe and experienced hands.

(b) Type of Surgical Approach: With the hopes of improving patient care, new technologies have been introduced. Such innovative advancements in the surgical approach increase the costs of minimally invasive bypass surgery.

(c ) Geographical location: The geographical location of the hospital from where you will undergo a minimally invasive heart bypass procedure matters a lot. Prices of this surgery in metropolitan cities is generally higher.

(d) Current medical condition: The surgical expenses of minimally invasive bypass surgery are associated with the age and medical condition of the patient and the type of investigations required.

Factors affecting Minimally Invasive Bypass Surgery cost in India:

(a) Cardiac Surgeon’s Fees: The charges for this kind of surgery totally depend upon the experience and skills of the surgeon. It is really important to approach surgeons who have a proven track record of delivering successful surgeries so that you would completely be in safe and experienced hands.

(b) Type of Surgical Approach: With the hopes of improving patient care, new technologies have been introduced. Such innovative advancements in the surgical approach increase the costs of minimally invasive bypass surgery.

(c ) Geographical location: The geographical location of the hospital from where you will undergo a minimally invasive heart bypass procedure matters a lot. Prices of this surgery in metropolitan cities is generally higher.

(d) Current medical condition: The surgical expenses of minimally invasive bypass surgery are associated with the age and medical condition of the patient and the type of investigations required.

What is the Minimally Invasive Bypass Surgery Recovery Time?

As minimally invasive bypass surgery is less intense than a traditional one, a patient takes 2 to 4 weeks to get fully recovered. Your healthcare provider will stay in touch with you to evaluate your progress and helps you manage the stress and anxiety that may come while recovering from a major surgery. The surgical team maintains a positive outlook throughout the process.

When to call the doctor?

Post minimally invasive bypass surgery, if a person feels chest pain or fever around 100.4 degrees Fahrenheit or unexplained chills or sweating, then that person must call the doctor. Symptoms of pus or more drainage from your incision or more swelling should also not be avoided.

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