MICS CABG
10 minutes read
3300+ PROCEDURES · LARGEST SINGLE CENTER EXPERIENCE
Coronary Bypass Without Cutting Any Bone
MICS CABG is an advanced minimally invasive technique for multi-vessel coronary bypass surgery. It preserves the safety and quality of open surgery while helping patients heal faster — with fewer complications and a 2.5-inch incision instead of a sawed sternum.
Largest
World Experience
3300+
Successful Procedures
Shortest
Hospital Stay
72
Hours
Rapid
Painless Recovery
7
Days
NEW RANDOMISED EVIDENCE · THE LANCET
The MIST trial: keyhole bypass beats sternotomy on recovery
Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST) was an investigator-initiated, international, open-label randomised controlled trial run at seven academic and community hospitals. Our centre was a participating site.
“For selected patients with multivessel coronary artery disease, MICS CABG performed by experienced teams improved patient-reported physical recovery at 1 month compared with sternotomy CABG, with no apparent safety penalty through to 12 months.”
Ruel M, Nambala S, Guo MH, et al. The Lancet. DOI 10.1016/S0140-6736(26)01288-2. Funded by Medtronic.
What is MICS CABG?
An advanced technique for multi-vessel bypass
The MICS CABG procedure is an advanced minimally invasive technique for multi-vessel coronary bypass. It offers several advantages over the traditional open technique while preserving both safety and quality of open surgery — helping patients heal faster and recover quicker without the complications.
Also called "Keyhole Bypass", the entire surgery is performed through a small cut below the left nipple between the ribs without cutting any bones. First described in 2006, it is now performed routinely at our centre.
3300+
Procedures Performed
7 days
Return to Normal life
72 Hours
Maximum Hospital Stay
2.5 inch
Single Keyhole Incision
How is MICS CABG performed?
The heart is positioned and stabilised using special tools called an Octopus and Starfish (manufactured by Medtronic). The bypass of the blocked vessels is then performed using specialised micro instruments — very different from open surgery where the breastbone or sternum is cut.
MICS CABG requires greater skill and training compared to open surgery. We perform it as a routine procedure, making us one of the most sought-after centres for training and observation — more than 200 surgeons from across the globe have visited us for education and training.
How MICS CABG is performed — using Medtronic Octopus & Starfish stabilisers through a single keyhole incision.
Open CABG vs MICS CABG
Open CABG cuts the breastbone (sternotomy), leading to extended recovery and chest trauma. MICS CABG avoids all of this.
FEATURE
Bone Cutting
Incision Size
Heart Exposure
Retractors
Blood Transfusion
Hospital Stay
Return to Activity
Wound Infection
Open CABG
Sternum split with electric saw
10–12 inches (chest)
Entire chest cavity exposed
Spread sternum, joint injury
Frequently needed
7–10 days
8–12 weeks◊
Risk of deep infection
MICS CABG
No bones cut
2.5 inches (side)
Minimal exposure
Not Required
96% do not need
Upto 72 hours
7-10 days
Near Zero, No Deep Infection
ADVANTAGES
Why choose the MICS CABG procedure?
A well-established technique that, in skilled hands, offers immense benefits compared to open surgery.
Rapid Recovery
Return to normal life within 7 days. Exercise and outdoor activity within 2 weeks.
Robotic Assistance
Further reduces pain and discomfort during and after surgery.
No Blood Transfusion
96% of MICS CABG patients don't need a blood transfusion.
No Infection
100% reduction in deep infection and near-zero wound infection rate.
Ideal for Older Patients
Both young and the old benefit. Less chest damage especially beneficial.
No Bones Are Cut
Unlike traditional surgery, no bones are cut — allowing rapid recovery.
Highly Accurate
Advanced tools and graft-flow measurement improve long-term outcomes.
Shorter Hospital Stay
Maximum 72 hours in hospital reduces hospital-acquired infections.
SAFETY & OUTCOMES
How safe is MICS CABG?
MICS CABG is an established operation performed routinely in the world's best heart surgery centres. With more than a decade of experience, our risk rates fall between 0.4% and 0.7% — significantly better than open surgery.
All vessels can be bypassed in a MICS CABG, including the right side. Approximately 73% of our patients receive grafts to all vessels — contrary to misconceptions spread by inexperienced surgeons.
>99%
Success Rate
< 1%
Need for CPB
73%
Receive Right Sided Graft
<1%
Deep Wound Infection
How do we know your grafts are working?
We use the MiraQ system for graft flow measurement on every patient. Each graft is imaged on the operating table to confirm the anastomosis is open and flows are normal. You are assured that every bypass was working when we left the operating theatre — and the patient's family receives a printout of our assessment immediately after the operation.
Dr Sathyaki P Nambala
Chief Cardiac & Thoracic Surgeon
Apollo Hospital, Bengaluru
Dr Nambala is one of the world's foremost experts in minimally invasive and robotic surgery. He is particularly known for his contribution to MICS CABG (Minimally Invasive bypass) and to robotic surgery in India
Take Your Surgical Experience Beyond The Ordinary
Safety & Efficacy
The MICS CABG procedure is extremely safe. With our experience of over 3300+ operations the risk is as low as 0.4%. The measuring tools we use also ensures that the operation is accurately performed.
Healing & Recovery
The small 2.5 inch cut heals rapidly. The likely chance for infection is extremely low and major complications are practically zero. Return to active life is usually as early as a week.
Diet & Diabetes
Its important to control blood sugar immediately after surgery to prevent infection and patients are usually given a regimen to follow. A low fat, high protien diet is usually recommended.
Activity & Exercise
Patients are encouraged to be independent and resume normal activity within 24 hours after surgery. After leaving the hospital they are encouraged to walk for a minimum of 30 min with no restrictions to bending, lifting weights or driving.
MICS CABG Surgery
People from different backgrounds choose minimally invasive CABG (MICS CABG) for varying needs. While some choose the procedure for a faster and less painful recovery, others choose it because they are too old to tolerate a major open surgery or because they want to return to work with the least amount of disruption. Whatever the reason, MICS CABG is a compelling choice for anyone who needs a coronary bypass. Below are a few of our patient stories that we found interesting.
1. Who needs CABG?
CABG or Coronary artery bypass grafting is required for patients who have one or more blocks in the blood vessels that supply the heart. These blocks are diagnosed after an angiogram.
2. Is minimally invasive surgery safe?
In experienced and skilled hands, Minimally Invasive Heart Surgery is very safe. Complications in minimally invasive cardiac surgery are a lot less when compared to open heart surgery.
3. Can CABG be done minimally invasive?
Yes. CABG can be performed minimally invasively through a small incision without cutting any bone, using specialized surgical instruments. This is called MICS CABG. Our experience with this technique is the largest in the world with over 3300+ procedures done so far. A robot can also be used to assist in some cases.
4. How long does pain last after CABG?
The pain of surgery is subjective. Typically, the pain lasts for 1 to 2 months after open CABG. More than physical pain, it’s the psychological trauma of undergoing an invasive procedure that affects patients. After minimally invasive CABG or MICS CABG pain usually disappears after 3 to 5 days.
5. What is the recovery time after MICS CABG?
The recovery time after MICS CABG is usually 1 week. However, recovery time can be longer if a patient is sick or unfit prior to the surgery. Patients who are active, with preserved heart function, well controlled diabetes and no other additional risk factors (eg: obesity, kidney failure, stroke) will recover faster.
Last Updated: 11 Jan 2026
Get In Touch
Let's Work Together!
micasblr@gmail.com
Phone
+91 819-719-6622
Address
Apollo Hospital
Bannerghatta Road
Bangalore 560076