Dr. Ravi Ghatnatti, a young promising Cardiac Surgeon is on study leave from KLES Dr. Prabhakar Kore Hospital, Belagavi is pursuing Master’s in Minimum Invasive Cardiac Surgery (Key Hole surgery) & Video Assisted Thoracic Surgery from Blackpool Victoria Teaching Hospitals NHS foundation trust, Blackpool, Lancashire, United Kingdom.
Dr. Ravi is of the firm opinion that, keyhole heart surgery is futuristic and can easily replace a large number of routine open-heart surgery procedures. Minimum Invasive Cardiac Surgery (MICS) techniques cause less pain and early recovery after the operation.
In his interaction with All About Belgaum, he spoke about the scope, technicalities & benefits/risks of the MICS procedure.
What is minimally invasive heart surgery?
Keyhole (also known as minimally invasive cardiac surgery) surgery is a term for heart procedures performed through one or more small cuts (incisions). In contrast, open-heart surgeries typically use one long incision down the front of your chest.
In MICS procedure, Surgeons insert small, high-powered cameras, tools, or robotic arms through the incisions. The surgeon guides the tools between your ribs to access your heart. Keyhole techniques may offer less scarring, reduced pain, and faster healing than open-heart surgeries. Open-heart surgeries typically involve cutting through your breastbone (sternum) to reach your heart.
Which type of heart surgeries could be performed through MICS?
The following surgeries could be done through MICS technique:
• Coronary artery bypass surgery
• Aortic valve replacement
• Mitral valve repair or replacement
• Atrial septal defect and patent foramen ovale closure
• Saphenous vein harvest for coronary artery bypass surgery
• Tricuspid valve repair or replacement
What are the benefits?
The potential benefits of keyhole heart surgery when compared with open-heart surgery can include the:
• Less blood loss
• Lower risk of infection
• Reduced trauma and pain
• Shorter time in the hospital, faster recovery, and quicker return to normal activities
• Smaller, less noticeable scars
In brief can you explain technicalities of MICS?
• Make one or more small incisions on the side of your chest.
• Insert small surgical tools or robotic arms through the incisions.
• Guide the tools between your ribs to reach your heart.
• Repair holes in the heart, bypass the blocked arteries, replace a heart valve, place a device, or remove tumors.
• Close the incisions with stitches.
How long does keyhole heart surgery take?
Keyhole heart surgery usually takes approximately four hours.
What happens after keyhole heart surgery?
A patient will be in ICU for 2-3 days in the intensive care unit (ICU) after keyhole heart surgery. Further, 3-4 days in the ward/room. A Physiotherapist will make the patient perform breathing exercises, and make the patient walk, a dietician will help to improve the nutrition levels. Usually, a patient will be discharged from the hospital on the 7th day.
How long does it take to recover from keyhole heart surgery?
Most people return to their usual activities within two to four weeks. You’ll need to avoid heavy lifting, strenuous exercise, driving for few weeks.
Patient is advised to perform regular exercise in their homes and adopt to healthy balanced diet.
Can all heart surgeries be done through Key Hole?
• Keyhole heart surgery isn’t the surgical option for all cases. Your doctor will decide by considering various parameters whether one is fit for MICS or not.
• To determine whether Keyhole heart surgery is the best option, your doctor will likely review your medical history and order tests to get more information about your heart health.
• Keyhole heart surgery is a complex surgical procedure that requires training and experience. This can be offered in a medical center with surgeons and a surgical team who have the needed expertise in performing keyhole procedures.
• Keyhole heart surgery can involve risks similar to open-heart surgery, such as:
• Irregular heart rhythms (arrhythmias)
• In rare cases there could be Death
• Also, keyhole surgery may need to be changed to open-heart surgery, if your surgeon thinks it’s unsafe to continue with the keyhole approach.
Dr. Ravi Ghatnatti, M.Ch (Minimum Invasvie Cardiac Surgeon)
Blackpool Victoria Teaching Hospitals NHS foundation Trust,
Blackpool, Lancashire, United Kingdom.