What does “minimally invasive” really mean?
When people hear the term “minimally invasive,” they expect less pain and faster recovery. But not all surgical techniques deliver that promise. Some still involve cutting through the breastbone or significant trauma to the ribs.
Totally Endoscopic Cardiac Surgery (TECS) is different. A single 2 to 2.5 cm incision is made in the natural spaces between the ribs on the right side of the chest. Through that micro-opening, a specially trained cardiac surgeon performs complex heart procedures using a high-definition camera and customized tools. No bone cutting. No spreading the ribs.
The hidden cost of bone trauma
Bone takes time to heal, that’s especially true for the sternum. Following a traditional open-heart procedure, the sternum is wired together, and the patient is placed on restrictive sternal precautions for 6 to 12 weeks until the bone is fully fused. This dictates one’s ability to drive, lift a grocery bag or push themselves out of a chair – it even affects sleep position.
Compare the Incisions: A traditional sternotomy incision requires healing the entire length of the breastbone, while TECS uses a truly minimally invasive approach.
During TECS, the chest wall remains completely intact. “By using totally endoscopic techniques, we’re able to preserve the patient’s primary bone structure,” states Dr. Mario Castillo-Sang, an internationally recognized cardiothoracic surgeon at St. Elizabeth and a global leader in Totally Endoscopic Cardiac Surgery. “We are essentially removing the body’s greatest recovery obstacle, allowing the patient to immediately focus all their energy on healing their heart, not the bone.”
Regaining simple freedoms has a powerful impact on confidence and emotional well-being. TECS patients return to everyday activities in days or a couple of weeks, not months – making it a real game-changer for quality of life.
The skill behind the technique
Performing heart surgery through a tiny opening is not about smaller instruments: it’s about a completely different way of performing surgery. The surgeon operates entirely by viewing a magnified, high-resolution video feed from a camera inserted through a 1cm port. St. Elizabeth is one of only two centers in the U.S. to integrate state-of-the-art 3D 4K endoscopic technology into the cardiac operating rooms. This device provides unparalleled clarity and depth perception.
Navigating tight spaces with limited range of motion requires exceptional dexterity and mastery of specialized equipment. The surgeon retains the tactile feedback they rely on in open surgery because they are holding and maneuvering the instruments. Therefore, visual judgement and refined hand-eye coordination are essential to the prompt and safe completion of the operation.
“This is one of the most technically challenging forms of heart surgery,” says Dr. Castillo-Sang. “Proficiency comes from repetition.” TECS demands a level of control that takes training and hundreds of cases to achieve.
The versatility of TECS
TECS isn’t a trend, it’s the future. At St. Elizabeth this innovative approach is used to safely and effectively treat an ever-expanding array of heart conditions, including:
- Mitral valve repair and replacement
- Mitral annular calcification (MAC)
- Tricuspid, aortic and multi valve surgery
- Atrial septal defect (ASD) closure
- Surgical ablations for atrial fibrillation (AFib)
- Cardiac tumor removal
Our St. Elizabeth cardiac surgery team performs totally endoscopic minimally invasive procedures with a level of expertise that ranks among the very best – not just in the nation, but across the globe.
A new chapter in heart surgery recovery
For decades, heart surgery meant weeks of restrictions and months of waiting to feel normal again. Totally Endoscopic Cardiac Surgery changes that narrative. Recovery is about regaining independence sooner and returning to the moments that matter most – whether that’s lifting a grandchild, playing golf or simply walking your dog.
Watch & Learn: Join Dr. Castillo-Sang as he explains how this innovative technique works, who it’s for and why it’s changing the future of heart surgery. https://www.youtube.com/watch?v=ufFEmnEbsys
Heart surgery without the heartbreak
If heart surgery is part of your treatment plan, ask if Totally Endoscopic Cardiac Surgery is right for you.
To learn more about the St. Elizabeth Cardiac Surgery Program, visit stelizabeth.com/heartsurgery
Call (859) 301-9010 to schedule a consultation with Dr. Castillo-Sang or complete our online request form.
