Minimally Invasive CABG Heart Surgery

Minimally Invasive CABG Heart Surgery in India came in the early 2000s, but became in frequent practice after 10 years. The surgery facilitates improved blood circulation in any patient with minimal invasion. Minimally Invasive Coronary Artery Bypass Grafting (CABG) is a heart surgery technique performed without opening the full chest. Instead of a large sternotomy, the surgeon accesses the heart through small incisions between the ribs, significantly reducing trauma, recovery time, and complications. 

Coronary Artery Bypass Grafting (CABG) has long been a critical surgical option for patients with blocked heart arteries. Traditionally performed through open-heart surgery, medical advancements now allow this life-saving procedure to be done using minimally invasive techniques. This method is especially gaining popularity in India due to its precision, faster recovery, and lower risks. 

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    Types of Minimally Invasive CABG Surgery

    Minimally invasive CABG surgery refers to advanced techniques that avoid the need for full sternotomy (cutting through the breastbone). These methods are designed to reduce trauma, scarring, and recovery time while still achieving excellent outcomes for coronary artery disease. 

    Minimally Invasive CABG Heart Surgery

    Minimally Invasive CABG Heart Surgery

    Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)
    MIDCAB is one of the most common types of minimally invasive CABG surgeries, performed without opening the chest bone. Instead, the surgeon makes a small incision on the left side of the chest, between the ribs. This technique is usually done on a beating heart (off-pump), without using a heart-lung machine. It’s best suited for patients who need a single or double bypass, particularly when the blockage is in the left anterior descending (LAD) artery. MIDCAB significantly reduces hospital stay, post-surgery pain, and recovery time, making it a preferred choice for eligible patients.
    Totally Endoscopic Coronary Artery Bypass (TECAB)
    TECAB is the most advanced and minimally invasive CABG heart surgery procedure, done entirely through small keyhole incisions using robotic surgical arms. A high-definition 3d camera guides the surgeon, who operates through a robotic console, allowing incredible precision. This method can be performed on a beating heart or with the support of a heart-lung machine, depending on the complexity of the case. TECAB is ideal for selected patients with limited blockages and overall stable health. Since there’s no large incision or sternotomy, patients recover quickly with minimal visible scarring and a lower risk of infection.
    Robot-Assisted CABG
    In robot-assisted CABG, the surgeon uses robotic technology to assist in harvesting grafts and performing parts of the bypass through small chest incisions. Although it may still involve a small incision for accessing the heart directly, the robot provides enhanced dexterity and accuracy. This approach allows for less trauma to the body and improves overall surgical outcomes. Robot-assisted CABG is especially beneficial for patients requiring precision in complex areas, and it may be combined with traditional methods or even angioplasty, depending on the patient’s condition. The high success rate and quicker recovery time make this an evolving technique in modern cardiac care.
    Thoracoscopic CABG
    Thoracoscopic CABG is performed using a thoracoscope (a small camera), inserted through tiny incisions in the chest wall. This method avoids both sternotomy and large cuts, focusing on visualising and operating within the chest using specialised instruments. Like MIDCAB, this procedure is often done on a beating heart and is typically used when only one or two arteries need to be bypassed. The main benefits include significantly less pain, reduced blood loss, and early mobility post-surgery. This approach is best suited for patients with isolated blockages who want a faster recovery and minimal physical trauma.
    Hybrid Coronary Revascularization (HCR)
    Hybrid Coronary Revascularization is a combination of surgical and interventional cardiology techniques. In this method, one artery—often the critical LAD—is treated with a minimally invasive bypass, while other blockages are addressed using angioplasty and stents. This hybrid approach offers the best of both worlds, especially for patients with multi-vessel disease where some arteries are more suited for stenting. HCR is usually performed in a specially equipped hybrid operating room that supports both surgery and catheter-based procedures. It allows for tailored treatment, fewer incisions, and a quicker overall recovery compared to full CABG surgery.

    Procedure of Minimally Invasive CABG

    The procedure is also known as MICS CABG. The Minimally Invasive Coronary Artery Bypass Grafting (CABG) procedure in India is a highly advanced and patient-friendly alternative to traditional open-heart surgery. It is designed to reduce trauma to the chest wall, shorten hospital stays, and allow faster recovery, while effectively treating blocked coronary arteries.

    The procedure is defined in three steps, and there is an actual in-depth procedure. 

    Preparation for Surgery
    At first, the heart rate, oxygen levels, and vital signs are closely monitored. For better treatment and no risk in the surgery, the patient is given general anaesthesia. The anatomical position for the incision and ECG of the patients are always observed before surgery. Before the surgery, the patient undergoes a complete cardiac assessment, which includes ECG, echocardiography, blood tests, chest X-rays, and coronary angiography. These tests help the cardiologist and cardiothoracic surgeon determine the number and location of the blockages and assess whether the patient is suitable for a minimally invasive approach.
    Surgery Procedure
    On the day of the surgery, the patient is taken into a high-tech operation theatre and given general anaesthesia to ensure complete unconsciousness and pain control during the procedure. The chest area is sterilised, and all monitoring devices are connected to track heart rate, blood pressure, and oxygen levels throughout the operation.
    • The patient is given general anaesthesia
    • A small incision (5–10 cm) is made on the left side of the chest between the ribs, usually in the 4th or 5th intercostal space
    • Unlike traditional CABG, the breastbone (sternum) is not cut.
    • The heart rate, oxygen levels, and vital signs are closely monitored.
    • Using special retractors and tools, the surgeon carefully reaches the heart through this small space.
    • A camera (thoracoscope) might be used for better visualisation in some cases
    • Typically, the left internal mammary artery (LIMA) is used as the graft.
    • It is carefully separated from the chest wall to be connected to the blocked coronary artery.
    • The heart is kept beating (off-pump) during the surgery.
    • A stabilising device holds the specific area of the heart still while the surgeon works.
    • The LIMA is then connected (anastomosed) to the affected coronary artery below the blockage.
    • Precision is crucial here for proper blood flow restoration.
    • After the grafting is completed and checked for patency, the incision is carefully closed in layers using absorbable sutures.
    • A drainage tube may be placed temporarily to remove excess fluids.
    Recovery & Rehabilitation: Minimally Invasive CABG Heart Surgery
    Patients typically stay in the hospital for about 4 to 6 days. Recovery is much quicker compared to open CABG or open Heart Surgery, and most patients can return to daily activities within 3 to 4 weeks. Cardiac rehabilitation and lifestyle modifications are recommended to ensure long-term heart health. The procedure of minimally invasive CABG surgery in India is performed by skilled cardiac surgeons in some of the world’s best-equipped hospitals. With reduced risks, minimal scarring, and quicker healing, it has become a preferred choice for eligible patients both locally and internationally.

    MICS Heart Surgery Cost in India: Best Minimally Invasive Cardiac Surgery Hospital in India 

    Apart from the treatment option, a patient considers the charges of the hospital and the surgeon. The cost of any surgery depends on the anesthesia, medications and treatment given to the patient. There are many treatment forms depending on the condition of the patient.  First and foremost is the hospital’s infrastructure and location Renowned cardiac hospitals in metro cities like Delhi, Mumbai, or Bangalore often charge more due to advanced technology, experienced surgeons, and higher operational costs.

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       Another major factor is the surgeon’s expertise and reputation. Cardiothoracic surgeons with extensive experience in minimally invasive techniques may have higher consultation and surgical fees. The type of minimally invasive CABG performed, such as MIDCAB, TECAB, or robotic-assisted surgery, also influences the MICS heart surgery cost in India.

      Robotic procedures are the most expensive due to the high-tech equipment involved.

      Type of MICS CABG Procedure

      Description

      Estimated Cost (INR)

      MIDCAB (Minimally Invasive Direct CABG)

      Beating heart, small incision through the ribs

      ₹3,50,000 – ₹4,50,000

      TECAB (Totally Endoscopic CABG)

      Keyhole incisions with robotic arms

      ₹5,00,000 – ₹6,50,000

      Robot-Assisted CABG

      Small incision + robotic precision for complex bypass

      ₹5,50,000 – ₹7,50,000

      Thoracoscopic CABG

      Thoracoscope-guided, very small incision

      ₹3,80,000 – ₹4,80,000

      Hybrid CABG (CABG + Stenting)

      Surgical bypass + stenting in a hybrid operating room

      ₹4,50,000 – ₹6,50,000

      There are also city-wise differences in the procedure. It depends on the infrastructure of the hospital and the experience of the surgeon what they are going to charge the patient. Here is the cost structure for different cities: 

       

      City

      Estimated MICS CABG Cost (INR)

      Notable Hospitals

      Delhi NCR

      ₹4,00,000 – ₹7,50,000

      Medanta, Fortis Escorts, AIIMS

      Mumbai

      ₹4,50,000 – ₹7,00,000

      Asian Heart Institute, Kokilaben Hospital

      Bangalore

      ₹4,00,000 – ₹6,50,000

      Narayana Health, Manipal Hospitals

      Chennai

      ₹3,80,000 – ₹6,00,000

      Apollo Hospitals, MIOT International

      Hyderabad

      ₹3,50,000 – ₹6,00,000

      Yashoda Hospitals, KIMS

      Kolkata

      ₹3,50,000 – ₹5,50,000

      AMRI Hospital, Fortis Anandapur

      Ahmedabad

      ₹3,20,000 – ₹5,00,000

      CIMS Hospital, Sterling Hospitals

      Pune

      ₹3,80,000 – ₹5,80,000

      Ruby Hall Clinic, Jehangir Hospital

      Best Heart Surgeons for MICS: Minimally Invasive CABG Heart Surgery 

      From the very beginning, India has been the home for talents and the residence of the best Doctors across the globe. Most of them believe in a personalised treatment system, not a general one. Such doctors are trained in the repudiated International training centres and have passed years of practice. They are treating patients without a second thought of discrimination and according to the surgical principles defined by the World Health Organization. Here is the name of some great Indian Cardiologists with their specialization.

      Dr. Naresh Trehan

      Dr Naresh Trehan
      Medanta – The Medicity

      Dr. K. M. Cherian

      Dr. K. M. Cherian
      Frontier Lifeline Hospital

      Dr. Ashok Seth

      Dr. Ashok Seth
      Fortis Escorts Heart Institute

      Dr. Devi Prasad Shetty

      Dr Devi Prasd Shetty
      Narayana Institute of Cardiac Sciences

      Dr. M. R. Girinath

      Dr. M. R. Girinath
      Apollo Hospitals

      Dr. Ramakanta Panda

      Dr. Ramakanta Panda
      Asian Heart Institute

      Dr. R. Ravi Kumar

      Dr. R. Ravi Kumar
      Chettinad Super Speciality Hospital

      Dr. Z. S. Meharwal

      Dr. Z. S. Meharwal
      Dr. Z. S. Meharwal
      Doctor's Name

      Hospital / Institute

      Hospital / Institute

      Special Mention

      Dr. Naresh Trehan

      Medanta – The Medicity

      Gurugram

      Pioneer in MICS and robotic heart surgeries in India

      Dr. K. M. Cherian

      Frontier Lifeline Hospital

      Chennai

      Globally renowned cardiac surgeon with decades of MICS experience

      Dr. Ashok Seth

      Fortis Escorts Heart Institute

      New Delhi

      Leading name in cardiac sciences, including hybrid CABG

      Dr. Devi Prasad Shetty

      Narayana Institute of Cardiac Sciences

      Bangalore

      Known for low-cost, high-quality heart surgeries

      Dr. S. Radhakrishnan

      Apollo Hospitals

      Chennai

      Expert in minimally invasive valve & bypass procedures

      Dr. M. R. Girinath

      Apollo Hospitals

      Chennai

      Padma Bhushan awardee with vast MICS expertise

      Dr. Ramakanta Panda

      Asian Heart Institute

      Mumbai

      Known for complex MICS & beating heart surgeries

      Dr. R. Ravi Kumar

      Chettinad Super Speciality Hospital

      Chennai

      One of the early adopters of robotic CABG

      Dr. Z. S. Meharwal

      Fortis Escorts Heart Institute

      New Delhi

      Over 30 years in MICS and cardiac surgery innovation

      Dr. Rajesh Sharma

      AIIMS

      New Delhi

      Specialises in pediatric and adult minimally invasive CABG

      We Care Health Services for Minimally Invasive CABG Heart Surgery

      We Care Health Services is an assisted Programme for various surgeries in India. There are multiple hospitals in various cities of India which are led by the organisation. If you are concerned about the Doctors and the treatment, you can talk to the experts in an online mode. The heart is an essential organ, but has narrow arteries and leads to a limited supply of blood in the coronary walls because of Coronary Artery Diseases (CAD). 

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        For Various heart surgeries, Including Pacemaker Implant and Open heart/traditional surgeries, We Care is assisting medical tourism in India. Here are some unique points about the surgeries and services offered by them: 

        • Extensive patient care based on personalised treatment. 
        • Multiple centres in various cities of India, with no travel issues during surgery. 
        • The emergency care unit is available in all centres if there are risks involved in the services. 
        • Some hospitals offer bundled packages that include surgery, hospital stay, and follow-up consultations.
        • Known for its experienced cardiology team and state-of-the-art facilities.

        • Hospitals equipped with robot-assisted systems, 3d imaging, and high-precision surgical tools tailored for minimally invasive techniques.
        • The hospitals will proudly share their success statistics, patient recovery data, and low infection or complication rates.
        • The best care comes from a team effort: cardiologists, anesthesiologists, nurses, physiotherapists, and ICU staff working in sync.
        • Hospitals will clearly outline costs, procedures, and recovery expectations. No hidden surprises.
        • Accredited with NABH, JCI, or ISO-certified hospitals reflect international standards in safety, hygiene, and patient care.

        Minimally invasive CABG vs CABG- What is the Difference? 

        Minimally invasive CABG heart surgery (Coronary Artery Bypass Grafting) is a modern alternative to traditional open-heart CABG, offering the same life-saving benefits with significantly less trauma to the body. Unlike conventional CABG, which requires a large incision through the breastbone, minimally invasive CABG is performed through small incisions between the ribs, avoiding the need to open the chest completely. This technique results in less pain, reduced blood loss, fewer complications, and a much faster recovery time. Patients undergoing minimally invasive CABG heart surgery often return to daily activities weeks earlier than those who have traditional CABG. 

        Aspect

        Minimally Invasive CABG Heart Surgery

        Traditional CABG (Open-Heart Surgery)

        Incision Type

        Small incisions (5-10 cm) between ribs

        Large incision (20-25 cm), full sternotomy (chest opened)

        Sternum Cutting

        No cutting of the breastbone

        Yes, complete splitting of the sternum

        Scarring

        Minimal, barely visible scars

        A prominent scar on the chest

        Pain & Discomfort

        Significantly less post-op pain

        Higher pain and discomfort due to bone and muscle trauma

        Risk of Infection

        Lower due to smaller wounds

        Higher risk due to open chest and longer exposure

        Hospital Stay

        3 to 5 days (average)

        7 to 10 days (average)

        Recovery Time

        2 to 4 weeks for normal activity

        6 to 12 weeks (longer recovery, especially for the elderly)

        Blood Loss

        Minimal

        Greater blood loss may require transfusion

        Use of Heart-Lung Machine

        Often avoided (off-pump technique)

        Frequently used (on-pump)

        Cosmetic Benefit

        Much better (smaller, hidden incisions)

        Large visible scar down the chest

        Suitability

        Ideal for 1–2 vessel blockages, younger patients, fewer comorbidities

        Suitable for complex, multi-vessel disease

        Surgical Expertise Needed

        High – requires specialised MICS surgeons and equipment

        More commonly available and practised

        Recovery Environment

        Faster return to daily life, minimal physiotherapy

        Longer rehabilitation often requires more support

        Frequently Asked Questions:

        1What is CABG full form?
        MICS CABG stands for Minimally Invasive Coronary Artery Bypass Grafting. It is a modern heart surgery technique where blocked arteries are bypassed through small chest incisions, without opening the breastbone. This approach reduces pain, recovery time, and infection risk while offering excellent long-term results.
        2What is the Life expectancy after bypass surgery?
        Life expectancy after bypass surgery varies, but many patients live 10 to 20 years or more, especially with healthy lifestyle changes and regular medical care. Factors like age, heart function, diabetes, and smoking impact outcomes. For many, bypass surgery significantly improves both quality of life and survival by restoring proper blood flow to the heart.
        3What is Recovery Time After CABG Surgery?
        Recovery time after CABG (Coronary Artery Bypass Grafting) surgery typically ranges from 6 to 12 weeks. Most patients stay in the hospital for 5 to 7 days, followed by gradual healing at home. Full recovery includes wound healing, regaining strength, and returning to daily activities, often with the help of cardiac rehabilitation for better heart health.
        4Is MICS surgery safe?
        Yes, MICS (Minimally Invasive Cardiac Surgery) is generally very safe when performed by experienced surgeons in specialised centres. It uses small incisions, avoids cutting the breastbone, and causes less trauma to the body, which reduces the risk of infection, bleeding, and complications. Patients typically experience faster recovery, less pain, and shorter hospital stays. Though not suitable for all cases, MICS surgery is a proven, effective option for many with blocked arteries, valve issues, or structural heart problems.
        5What is the success rate of MICS?
        The success rate of MICS (Minimally Invasive Cardiac Surgery) is very high, typically ranging from 95% to 98%, depending on the type of procedure, the patient’s condition, and the hospital’s expertise. For eligible patients, MICS offers excellent long-term outcomes, lower complication rates, and a significantly faster recovery compared to traditional open-heart surgery. When performed at well-equipped centres by experienced surgeons, MICS is considered both safe and highly effective for treating coronary blockages, valve disorders, and other cardiac issues.
        6What are the risks of MICS?
        Minimally Invasive Cardiac Surgery (MICS) carries several risks, including bleeding, infection, blood clots, and damage to surrounding tissues. There's also a risk of heart arrhythmias, which may require treatment. Some patients may experience prolonged recovery times or adverse reactions to anaesthesia. Additionally, MICS might not be suitable for patients with complex heart conditions or severe comorbidities. As with any surgery, there is a potential for complications, but MICS generally offers a safer alternative with shorter recovery times compared to traditional surgery.
        7Is MICS a robotic surgery?
        Minimally Invasive Cardiac Surgery (MICS) is not inherently robotic surgery, though it can be performed using robotic assistance. MICS involves small incisions and specialised instruments to perform heart surgery with minimal disruption to the body. Robotic-assisted surgery is a specific type of MICS, where a surgeon uses robotic systems, like the da Vinci Surgical System, to perform more precise movements. While robotic surgery can be a part of MICS, not all MICS procedures involve robotics.