Department of Cardiovascular Surgery

Mini-Invasive and Endoscopic Cardiovascular Surgery

The Mini-Invasive and Endoscopic Cardiovascular Surgery Unit is dedicated to the treatment of adult cardiovascular pathologies with the most advanced minimally invasive techniques. Such methods, when applicable, allow to intervene on the heart with minimal invasiveness, and therefore less trauma for the patient. The Unit, in particular, is a reference for the reparative surgery of the mitral, aortic and tricuspidal valve in "cardiac endoscopy", a minimally invasive technique performed entirely in videothoracoscopy, which is currently the last frontier of mininvasivity.

The team has a high specialization in minimally invasive videothoracoscopic cardiosurgery, which requires the use of 3D endoscopic cameras and special instrumentation to operate in the chest and heart cavities with maximum precision, through small incisions. To learn more about thoracoscopic minimally invasive surgery (cardiac endoscopy) the answers to the most frequently asked questions are available below.

HOW DOES THE TECHNIQUE WORK?

With the cardiac endoscopy the patient is operated without practicing the "sternotomy", that is to say the classical surgical incision, but with a cut of about three or four centimeters in which an endoscopic camera is introduced, that reaches the heart and allows a complete and detailed vision. Once the extracorporeal circulation has been implanted, the surgeon operates using specific endoscopic instruments that allow for minimal invasiveness of the heart. This is a new way of operating: the surgeon, in fact, works directly on the heart no longer looking inside the chest - it would be impossible given the reduced size of the incision - but on the screen connected to the camera, which gives an extremely enlarged and detailed vision of the heart, making precise and targeted surgical gestures possible.

WHAT ARE THE BENEFITS OF ENDOSCOPY FOR THE PATIENT?

This technique has significant advantages for the patient: it allows a significant reduction in surgical trauma and pain, a lower incidence of infections, a shorter hospitalization and a faster post-operative recovery. In addition, the small size of the surgical cut offers a better aesthetic result.

WHERE IS SURGICAL CUTTING DONE?

The surgical incision is usually made on the contour of the areola of the nipple in men, or under the breast in women, resulting in little visibility.

WHAT ARE THE DISEASES THAT CAN BE TREATED WITH THIS TECHNIQUE??

Minimally invasive videothoracoscopic surgery allows the treatment of mitral, aortic and tricuspid valve pathologies, even in the most complex cases. With this surgical approach it is also possible to remove heart tumors, correct some congenital defects and heart rhythm disorders such as atrial fibrillation.

ARE THERE CONTRAINDICATIONS TO THE APPLICATION?

There are no absolute contraindications to the application of cardiac endoscopy, but some particular contraindications relating to certain physical or clinical conditions of the patient. For example, this type of surgery is not suitable for people who have already performed cardiac surgery in the past or who suffer from major lung or chest diseases. Under these conditions, an in-depth specific assessment is carried out to assess the risks and benefits of the intervention on a case-by-case basis.

HOW MANY OPERATIONS HAVE BEEN CARRIED OUT?

With this method of access, Dr Al Jaber has performed at the Monzino over 150 procedures of mitral, tricuspid and cardiac mass removal valvular plastics. The Doctor has personal cases of about 1,000 cases treated with this method.