Traditionally keyhole heart valve surgery involves opening the breastbone and performing the operation through a 20cm incision on the patient’s side. But Royal Brompton & Harefield Hospitals, based in London, is the only UK centre using a new totally endoscopic technique for mitral valve repair and aortic valve replacement.
Higher precision
Consultant cardiac surgeon Mr Toufan Bahrami, who is nationally and internationally recognised in minimally invasive, endoscopic cardiac surgery, uses the novel approach to avoid a large incision or division of the sternum.
He enters the chest through a tiny cut and spreads the soft tissue. With another incision, a 4K resolution 3D camera is used which shows the inside of the chest via a high-definition TV monitor in the operating theatre. Endoscopic instruments are mechanically manipulated, and the surgeon can intervene manually if required.
Quicker recovery
Patients of all ages are eligible for the technique, which has a much faster recovery time. During open heart surgery, the breastbone is opened, recovery takes three months and patients cannot drive or lift anything heavy for two months. With the minimally invasive approach, recovery is one month. But with totally endoscopic heart surgery, patients can return to normal daily activity within three weeks.
“Because the chest is not opened, they can breathe faster, mobilise quicker and recover quicker. This technique is a game-changer for patients, reducing the risk of infection and the length of time in hospital,” explains Mr Bahrami.
Compared to other techniques, the length of operations is similar, but hospital stay is reduced, and there is minimal scarring.
Training and teaching
The approach has training advantages too, as the procedure is displayed on monitors and can be recorded. Mr Bahrami says 4K image quality on the monitor also enables a more accurate assessment of organs.
“To me, this is the future of cardiac surgery; and any patient, whether low risk or high risk, can have this operation,” he adds.
Having conducted many operations, Mr Bahrami trains other surgeons in the technique and works with surgical companies to develop and improve the procedure further.
- To find out more visit: rbhh-specialistcare.co.uk/totallyendoscopic
