Oakwood surgeons expand minimally invasive surgery options

A technique now being used by Oakwood doctors can substantially reduce the risk and recovering time of some types of heart surgery.

Timothy Sell, MD, and Reza Dabir, MD, recently performed the first minimally invasive single vessel bypass at Oakwood Hospital & Medical Center (OHMC) in Dearborn. Using a 7-cm incision under the left breast, the surgeons performed the procedure that would have previously required open-heart surgery—and can be an alternative to Davinci robotic surgery.

“I think this compares favorably with the robotic technique,” said Dabir. “Through this procedure you can actually do three-vessel bypass in the three main areas of the heart. Obviously it does not require the robot and as such, I think it gives direct tactile sensation to the surgeon. It’s an efficient way of doing revascularization of the heart.”

Their first patient suffered from a significant blockage of the left main coronary artery, but was a risky candidate for traditional surgery due to other health issues. Rather than crack open the man’s breast bone, the surgeons were able to replace the artery through the small incision. Sell said the procedure requires less blood, reduces the risk of infection and greatly reduces the recovery time.

“A smaller incision means there is less tissue that is opened, less exposure for infection, faster healing, the chest remains more stable after the procedure,” said Sell. “Typically, there’s less use of blood transfusion; we’re able to take out the breathing tube from patients earlier—sometimes we’re able to take it out in the operating room.”

It requires less time to heal, he added.

“If you open the chest bone, it typically it takes six to eight weeks to heal to the point where it was as solid as it was before you opened it,” Sell said. “With this technique, a lot of times the structural integrity of the chest can be close to normal within a couple of weeks.”

Minimally invasive techniques for thoracic surgery are not new, but in the past they had primarily involved valve replacements. Coronary bypass procedures are relatively new, said Dabir, and improvements in technology have allowed for smaller and smaller incisions. The new technique can be effective for high-risk patients, but patients should ask their physicians about the best course of action to treat their conditions, said Dabir.

“You should look at the patient first and try to fit the different types of treatment and surgery to the patient, rather than fit the patient to the surgery,” he said. “You have to keep an open mind and discuss all options with the patient.