Many procedures can now be done without the traditional incision associated with “open heart” surgery. With traditional open-heart surgery, the entire breastbone is divided and opened to allow the surgeon access to the heart and great vessels. Minimally invasive and robotic approaches do not open the entire breastbone, but rather are approached through a partial opening of the breastbone or by working between the ribs. Some of the these procedures are done with the assistance of tele-manipulated instruments –often referred to as “robotic” surgery – while others are done using long thin instruments held by the surgeon. Both approaches are similar in that the operation is done without opening the entire breastbone. In most cases, a separate incision in the groin is necessary to allow connection of the heart lung machine.
A limited incision, whether on a portion of the breastbone or between the ribs, speeds the recovery following surgery. In addition, less invasive approaches are associated with lower need for blood transfusion, lower rates of infection, shorter lengths of stay, and for some patients lower mortality. Your surgeon will discuss with you if your condition could potentially be treated with a minimally invasive approach. Even if a minimally invasive procedure is planned, in rare cases, the procedure may need to be converted to a standard procedure for your safety.