Medical Science | Open Access | DOI: https://doi.org/10.37547/tajmspr/Volume08Issue02-13

Modern Roles And Future Horizons Of Minimally Invasive CABG: A Narrative Literature Review

Khalikulov Khusan Gazihanovich , PhD, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan
Tilavoldiyev Pahlavonmahmud Utkirbek ugli , Master’s degree, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan
Irisov Ortiqali Tulayevich , DSc, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan
Xaydarov Alisher Erkinovich , PhD, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan
Mirzaev Khondamir Alisher ugli , Senior teacher, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan

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.

Keywords

Minimally invasive surgery, Minimally invasive coronary surgery, Robotic cardiac surgery

References

Aye, W. M. M., Kiraly, L., Kumar, S. S., Kasivishvanaath, A., Gao, Y., & Kofidis, T. (2025). Mixed reality (holography)-guided minimally invasive cardiac surgery: A novel comparative feasibility study. Journal of Cardiovascular Development and Disease, 12(2), 49. https://doi.org/10.3390/jcdd12020049

Bonatti, J., Wallner, S., Crailsheim, I., Grabenwöger, M., & Winkler, B. (2021). Minimally invasive and robotic coronary artery bypass grafting—A 25-year review. Journal of Thoracic Disease, 13(3), 1922–1944. https://doi.org/10.21037/jtd-20-1535

Marin-Cuartas, M., Sá, M. P., Torregrossa, G., & Davierwala, P. M. (2021). Minimally invasive coronary artery surgery: Robotic and nonrobotic minimally invasive direct coronary artery bypass techniques. JTCVS Techniques, 10, 170–177. https://doi.org/10.1016/j.xjtc.2021.10.008

Qadrie, Z., Maqbool, M., Dar, M. A., & Qadir, A. (2025). Navigating challenges and maximizing potential: Handling complications and constraints in minimally invasive surgery. Open Health, 6, 20250059. https://doi.org/10.5334/oh.20250059

Raja, S. G. (2025). New clinical advances in minimally invasive coronary surgery. Journal of Clinical Medicine, 14(9), 3142. https://doi.org/10.3390/jcm14093142

Roshanfar, M., Salimi, M., Jang, S.-J., Sinusas, A. J., Kim, J., & Mosadegh, B. (2025). Emerging image-guided navigation techniques for cardiovascular interventions: A scoping review. Bioengineering, 12(5), 488. https://doi.org/10.3390/bioengineering12050488

Sadeghi, A. H., Bakhuis, W., van Schaagen, F., Oei, F. B. S., Bekkers, J. A., Maat, A. P. W. M., … Taverne, Y. J. H. J. (2020). Immersive 3D virtual reality imaging in planning minimally invasive and complex adult cardiac surgery. European Heart Journal - Digital Health, 1(1), 62–70.

Spenkelink, I. M., Heidkamp, J., Fütterer, J. J., & Rovers, M. M. (2022). Image-guided procedures in the hybrid operating room: A systematic scoping review. PLoS ONE, 17(4), e0266341. https://doi.org/10.1371/journal.pone.0266341

Spenkelink, I. M., Heidkamp, J., Verhoeven, R. L. J., Jenniskens, S. F. M., Fantin, A., Fischer, P., … Fütterer, J. J. (2024). Feasibility of a prototype image reconstruction algorithm for motion correction in interventional cone-beam CT scans. Academic Radiology, 31(6), 2434–2443. https://doi.org/10.1016/j.acra.2024.02.013

Spenkelink, I. M., Zhu, X., Fütterer, J. J., & Langenhuijsen, J. F. (2024). Feasibility of stereotactic optical navigation for needle positioning in percutaneous nephrolithotomy. World Journal of Urology, 42(1), 181–190. https://doi.org/10.1007/s00345-023-04371-x

Spenkelink, I. M., Heidkamp, J., Avital, Y., & Fütterer, J. J. (2023). Evaluation of the performance of robot-assisted CT-guided percutaneous needle insertion: Comparison with freehand insertion in a phantom. European Journal of Radiology, 162, 110753. https://doi.org/10.1016/j.ejrad.2022.110753

Tonutti, M., Elson, D. S., Yang, G.-Z., Darzi, A. W., & Sodergren, M. H. (2017). The role of technology in minimally invasive surgery: State of the art, recent developments and future directions. Postgraduate Medical Journal, 93(1097), 159–167. https://doi.org/10.1136/postgradmedj-2016-134566

Download and View Statistics

Views: 0   |   Downloads: 0

Copyright License

Download Citations

How to Cite

Khalikulov Khusan Gazihanovich, Tilavoldiyev Pahlavonmahmud Utkirbek ugli, Irisov Ortiqali Tulayevich, Xaydarov Alisher Erkinovich, & Mirzaev Khondamir Alisher ugli. (2026). Modern Roles And Future Horizons Of Minimally Invasive CABG: A Narrative Literature Review. The American Journal of Medical Sciences and Pharmaceutical Research, 8(2), 86–92. https://doi.org/10.37547/tajmspr/Volume08Issue02-13