Minimally Invasive Heart Surgery

Types

Mayo Clinic heart surgeons perform two types of minimally invasive heart surgery: robot-assisted and thorascopic. Both access the heart through small incisions in the side of the chest.

Robot-assisted heart surgery procedure at Mayo Clinic.

Enlarge

Surgical instruments are attached to robotic arms, controlled by the surgeon.

Enlarge

Robot-Assisted
The robotic system (the da Vinci system) used at Mayo and other centers uses computers to better visualize the heart's anatomy and to precisely manipulate the surgical instruments.

The surgeon sits at the remote control console and views the operating field on a video monitor, which shows a magnified view in high-definition video. As the surgeon manipulates the remote control unit, the motions are translated to the robotic arms at the operating table. Each robotic arm consists of multiple appendages connected by joints which can be moved similar to a human wrist. A second surgeon at the operating table exchanges surgical instruments on the robotic arms.

The robotic technology allows the surgeon to achieve the same level of precision as in traditional open-chest surgery, and in some cases, even greater precision. A number of studies have confirmed that robotic-assisted heart surgery is as effective as conventional open-chest surgery.

Thorascopic
Thoracoscopic surgery (sometimes referred to as a mini-thoracotomy) is technically simpler than robotic surgery. The surgeon inserts a thorascope containing a video camera into the chest to visualize the heart. Repair is performed with long-shafted instruments inserted through other small incisions between the ribs.

The main disadvantage of approaching the heart from the side of the chest rather than from above is the increased distance from the heart. The longer instruments required in this technique make performing precise surgical actions more challenging. However, in the hands of a skilled surgeon, many procedures can be very successfully performed with a thoracoscope.