Development in surgery has focused on minimizing the invasiveness of surgical procedures. Thus Surgeon does not require to directly touching or sees the structures on which they operate. Recent development in medical sciences such as video imaging, endoscopes technology, and instrumentation has made it possible to replace many traditional surgeries into minimally invasive surgery.

What is Minimally Invasive Surgery?

Minimally invasive surgery is performed through a small incision, often using specialized surgical instruments. The incision is about 3 to 4 inches instead of the 6- to 8-inch incision required for traditional surgery. Keyhole approaches or port-access techniques are also available for some types of surgery.

Types of minimally invasive cardiovascular surgeries include:

1. Coronary artery bypass graft (CABG) surgery,
2. Epicardial lead placement: placement of leads for biventricular pacemakers,
3. Atrial fibrillation,
4. Valve surgery.

Valve surgeries, including valve repairs and valve replacements, are the most common minimally invasive procedures. A small, 3- to 4-inch incision is made down the center of the sternum (breastbone), whereas the incision made during traditional valve surgery is about 6 to 8 inches long.

Strength of Minimally Invasive Surgery The benefits of minimally invasive surgery include:

1. A smaller incision,
2. A smaller scar,
3. Reduced risk of infection,
4. Less bleeding,
5. Less pain and trauma,
6. Decreased length of stay in hospital after the procedure: the average stay is 3 to 5 days after minimally invasive surgery, while the average stay after traditional heart surgery is 5 days,
7. Decreased recovery time: the average recovery time after minimally invasive surgery is 2 to 4 weeks, while the average recovery time after traditional heart surgery is 6 to 8 weeks.

Recent advances have reduced incision further and they are called Keyhole Approaches. They are also minimally invasive surgery

Keyhole Approaches

For some surgical procedures, an endoscopic or "keyhole" approach may be performed. This approach may also be referred to as port access surgery or video-assisted surgery. The port access surgery technique allows surgeons to use one to four small (5- 10 mm) incisions or "ports" in the chest wall between the ribs. An endoscope or thoracoscope (thin video instrument that has a small camera at the tip) and surgical instruments are placed through the incisions. The scope transmits a picture of the internal organs on a video monitor so the surgeon can get a closer view of the surgical area while performing the procedure. Types of surgeries that may be performed using the innovative port-access or "keyhole" approach include:

1. CABG surgery
2. Valve surgery
3. Biventricular pacemaker lead placement on the surface of the left ventricle

Advantages are same as mentioned above.

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