Modern Roles And Future Horizons Of Minimally Invasive CABG: A Narrative Literature Review
Abstract
Minimally invasive surgery (MIS) has undergone significant evolution over the past 25 years, fundamentally reshaping modern surgical practice. Compared with traditional open procedures, MIS is associated with reduced tissue trauma, lower infection rates, and faster postoperative recovery. This review highlights recent clinical and technological advances in MIS, with particular emphasis on minimally invasive coronary surgery (MICS) and the integration of advanced imaging technologies.
Major innovations include the widespread adoption of robotic surgical platforms, particularly the da Vinci robotic system, and the development of totally endoscopic coronary artery bypass (TECAB), which enables complete myocardial revascularization without median sternotomy. The emergence of hybrid operating rooms (ORs) has further improved procedural efficiency by combining sterile surgical environments with high-resolution three-dimensional imaging modalities, such as cone-beam computed tomography (CBCT). These facilities support complex image-guided interventions and allow the seamless combination of surgical and percutaneous techniques.
Immersive technologies, including Virtual Reality (VR) and Mixed Reality (MR), are increasingly applied in preoperative planning and intraoperative guidance, enhancing spatial orientation and visualization of complex cardiovascular anatomy. Additionally, artificial intelligence (AI) and machine-learning algorithms contribute to motion correction, image optimization, and real-time decision support during cardiovascular procedures.
Despite these advancements, important challenges remain, including steep learning curves for robotic techniques, high equipment and maintenance costs, and limited tactile feedback in current robotic systems. Imaging artifacts and radiation exposure also represent ongoing technical concerns. Future developments are expected to focus on multimodal imaging, haptic feedback integration, and patient-centered innovations to further enhance surgical precision and safety. Continued multidisciplinary collaboration and robust clinical validation are essential to translate these technological advances into improved patient outcomes.
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References
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