Page Under Maintenance
This page is currently under maintenance.
Please communicate at the hospital help desk for assistance.
Heart surgery often triggers anxiety — about pain, hospital stays, recovery time, and visible scars. Minimally invasive cardiac surgery is a revolutionary technique that addresses all of these concerns. Dr. Suresh Joshi, a pioneer of minimally invasive cardiac procedures in India with over 35 years of experience and nearly 20,000 surgeries to his credit, sits down with us to explain everything patients need to know about this modern approach to heart surgery.
The literal meaning of "minimally invasive" is doing an operation through the smallest possible cut and the smallest possible incision. In traditional open-heart surgery, a 7 to 8-inch incision is made across the chest, the sternum (breastbone) is cut, and the chest is opened wide to access the heart.
In minimally invasive cardiac surgery, the same operation is performed through a cut of just 2 inches — roughly one-fourth the size of a conventional incision. Crucially, no bone is cut and the ribs are not broken. In some cases, a thoracoscope (a small camera) is used to assist the surgeon inside.
The internal operation performed is identical to open-heart surgery. The difference is only in how the surgeon accesses the heart — and that difference changes everything for the patient.
Everyone knows that a broken bone takes six weeks to three months to heal. In conventional open-heart surgery, the sternum is cut, and that is exactly what takes so long to recover from — not the heart itself. Patients are typically discharged from the hospital in about eight days after open-heart surgery but cannot return to work for at least six weeks.
With minimally invasive surgery, patients are discharged in three to four days and can return to work within seven to ten days. That is a recovery time reduction of nearly one full month — a major advantage in today's competitive and demanding professional environment.
Because no bone is cut, the post-operative pain is dramatically lower. Bone pain is far more severe than soft-tissue pain, so patients undergoing minimally invasive surgery report significantly less discomfort throughout their recovery.
The 2-inch incision is so small that it is completely hidden beneath conventional clothing. It is not visible externally. For patients — especially younger ones and women — this is a meaningful quality-of-life benefit.
Minimally invasive procedures involve less blood loss during surgery, which means blood transfusions are required far less frequently. This reduces surgical risk and aids overall recovery.
Currently, approximately 40 to 50% of cardiac surgeries can be performed using minimally invasive techniques. Dr. Joshi notes that while the approach is advancing toward being applicable to the majority of patients, some selectivity is still applied.
Conditions well-suited for minimally invasive cardiac surgery include:
Dr. Joshi describes minimally invasive surgery as a natural bridge between traditional open-heart surgery and robotic cardiac surgery — combining the precision of conventional techniques with the benefits of a minimal-access approach.
This is a question many patients and families ask. The answer is that the cost is broadly similar between the two approaches.
While the hospital stay is shorter (which reduces costs), the minimally invasive procedure involves some additional technology such as a thoracoscope. These two factors largely offset each other, making the overall expense comparable. Given that both procedures cost roughly the same, and the minimally invasive approach offers substantially better outcomes for the patient, it should be the first option considered when the patient is a suitable candidate.
One of the most common dilemmas patients face is receiving conflicting recommendations — one cardiologist advising angioplasty, another advising bypass surgery. This creates real confusion and anxiety for patients and their families.
Dr. Joshi is clear: angioplasty and bypass surgery are not competitors. They are complementary procedures suited to different clinical situations.
After angioplasty, patients must strictly follow blood-thinning medication protocols. Over the course of their life, repeat angioplasties are often required — sometimes multiple times over five, ten, or more years. The patient remains under continuous cardiologist supervision indefinitely.
After bypass surgery, particularly with arterial grafts, the results are durable and long-lasting. The procedure addresses the root of the problem rather than managing it episode by episode.
A second or even third medical opinion is always welcome and encouraged. However, Dr. Joshi cautions that seeking too many opinions — especially from unverified online sources — can increase confusion rather than resolve it.
The most reliable reference point is the clinical guidelines issued by recognized medical associations such as the American College of Cardiology, the American Heart Association, and the European Society of Cardiology and Cardiac Surgeons. These guidelines provide evidence-based recommendations for when angioplasty is preferred versus when bypass surgery is the correct choice. Patients can access these guidelines online as a trustworthy reference when evaluating their options.
When asked about heart disease prevention, Dr. Joshi gives a clear and prioritized answer.
45 minutes to one hour of walking every day has prevented millions of people from developing heart disease. This single habit is the most powerful preventive tool available to anyone, regardless of age or fitness level.
Avoiding fatty foods in large quantities is important, but moderation is the key — not complete elimination. Balance matters more than restriction.
Tobacco in any form must be completely avoided. There is no safe level of tobacco use.
Chronic stress is a significant and often underestimated risk factor for heart disease. Dr. Joshi emphasizes the importance of maintaining a positive mental attitude — the idea of "all is well" is not just a motivational phrase but an active health strategy. However, he adds an important caveat: one can genuinely say "all is well" only after having done everything right — the exercise, the diet, the lifestyle. Stress-free thinking is the final layer, not a substitute for healthy habits.
Dr. Joshi has performed approximately 20,000 heart surgeries over his 35-year career, including around 1,000 minimally invasive procedures. His work spans adult cardiac surgery as well as complex paediatric cardiac surgery — correcting congenital heart defects in newborns and young children.
He shares two cases that reflect the depth of impact this work can have:
A young girl named Sneha, operated on at age three or four for a hole in the heart using minimally invasive technique, recovered fully, was adopted by a German family, and came back to meet Dr. Joshi 25 years later. That reunion was one of the most emotionally fulfilling moments of his career.
A boy who had a complex cardiac surgery performed when he was just four to eight days old went on to clear IIT, then received admission to MIT in the United States. His parents came specifically to share that news with Dr. Joshi. He is now over 25 years old and thriving.
As Dr. Joshi puts it, operating on children is a uniquely profound experience because correcting their heart defect early gives them an almost entirely normal life ahead. Nearly 90% of children with congenital heart defects can lead a near-normal life after surgery.
Jaslok Hospital's Cardiovascular Thoracic Department provides the full spectrum of cardiac care — from prevention and diagnosis to the most advanced surgical interventions — backed by decades of experience, outcomes data, and a multidisciplinary team.
|
Topic |
Key Point |
|---|---|
|
Minimally invasive surgery |
2-inch incision, no bone cutting, identical internal operation |
|
Hospital discharge |
3 to 4 days vs. 8 days for conventional surgery |
|
Return to work |
7 to 10 days vs. 6 weeks for conventional surgery |
|
Pain |
Significantly less — no bone pain |
|
Scarring |
Hidden under clothing, not externally visible |
|
Blood loss |
Reduced, fewer transfusions needed |
|
Suitable candidates |
~40 to 50% of cardiac surgery patients |
|
Cost comparison |
Broadly similar to conventional open-heart surgery |
|
Angioplasty vs. bypass |
Complementary, not competing — suited to different conditions |
|
Bypass surgery longevity |
15 to 20 years average benefit, longer with arterial grafts |
|
Heart disease prevention |
Daily walking, balanced diet, no tobacco, stress management |
|
Paediatric cardiac outcomes |
~90% of children with heart defects can lead near-normal lives |
For the complete conversation with Dr. Suresh Joshi on minimally invasive cardiac surgery, angioplasty vs. bypass, and heart disease prevention:
Watch the full video here: Minimally Invasive Cardiac Procedures | Jus Health for the People | Jaslok Hospital
This article is part of Jus Health — For the People, By the Experts, a public health awareness initiative by Jaslok Hospital and Research Centre, Mumbai. Subscribe to the Jaslok Hospital YouTube channel for more expert-led health content.