"minimally invasive": ? Definition vs use of the phrase

[CATDOG]

I'm confused about the use of the phrase "minimally invasive". My regular cardio told me to just go with the regular sternotomy to make sure the surgeon could see what he was doing. So I didn't ask about the incision at the consult. But at the end of the meeting the surgeon said he only does "minimally invasive" for AVR without other necessary procedures. But then he briefly described a sternotomy and scar about 6" long, which he said would not be all that small on a small person.

So then what makes it "minimally invasive"? I thought that term was for when they only used incisions between the ribs INSTEAD of a sternotomy. Is there a standard definition of this phrase? Or are some places using the term a bit liberally?

 

[epstns]

I always thought "minimally invasive" techniques were those that either did not use a sternotomy at all, or used only a partial sternotomy. My surgery was a full sternotomy, and the resultant scar is only about 5 inches long. Others I've met who had full sternotomies have scars up to 10-12 inches long. I wouldn't call mine minimally invasive, but it is cosmetically less obvious.

 

[Greg a]

As with Steve's my sternotomy was about 6-7 inches but my sterrnectomy is 12-13

 

[Bina]

CATDOG, just as Steve posted,
around this forum we use the term "minimally invasive" to describe the OHS procedure where the surgeon
enters between the ribs and doesn't cut the sternum.
You will also sometimes see the term "mini sternotomy" which is a partial cut of the sternum, and this procedure can
also be termed as minimally invasive.

 

[Lynlw]

min invasive heart surgery, is either smaller incisions between the ribs, mini- thoracotomy or where they cut part of the sternum which is a partial sternoty, and using a few small holes for robotic surgery is also called minimally invasive OHS.
The also do thoracotomies between the ribs that are NOT considerred min invasive because the incision can be pretty long. I think generally incisions that are 2-4 inches are considerred mini and full sternum/thoracotomy is usually at least 6-8 or at least the entire sternum is cut open.. To be even more confusing, the amount of area cut in a sternum can be longer than the incision in the skin and is quite often the case.
CCF has a couple good diagrams of the different incisions, here is some of the pages with diagrams http://my.clevelandclinic.org/heart/disorders/valve/mini_mv.aspx and http://my.clevelandclinic.org/heart/disorders/valve/mini_mv.aspx

 

[Nancy jane]

Hi.. this is my first time on this..and just found today; I"ll be joining this 'club' My big decison is tissue or Mech. (do not ask age !! and have talked about min. invasive..but now after reading the above... agggggg... it could be a full stern..thing but not as big. geeezzzzz.. actually I think I"m more nervous about the PRE tests; than the valve thing it self. I'll keep checking on on everyone. and wishing you the best for a great recovery and fun life. Nancy / St Louis Mo

 

[Luana]

It seems that different surgeons use the term in different ways. When I asked about it, surgeon said he could do a mini-thoracotomy, which is what I wanted. I didn't want it for the cosmetic reasons, but because I've never had a broken bone and thought for sure the broken sternum must hurt when healing, at least I read about that here, and the run-over-by-a-truck feeling that reported a lot here, too.

I was fortunate my surgeon could do this approach; it's not always a good choice for everyone.

Technically this approach is supposed to hurt more, and I don't have a sternotomy to compare it to, but the pain I had after surgery was very minimal. I felt sore more than I felt pain. Felt a little more sore when I got home and was using my arm and doing a few things, but nothing to make me cringe or stop in my tracks.

 

[CATDOG]

Thanks everybody. Good to know that this surgeon isn't the only one using the term loosely or to mean basically anything short of a full sterotomy. So now I'm still left wondering exactly what he meant.
I guess I've got some time yet, and haven't decided whether to seek another opinion.

 

[epstns]

Nancy Jane - I, too, was more anxious about the tests than the valve surgery itself. Why don't you start another thread so we all can help?

 

[Jkm7]

Thanks everybody. Good to know that this surgeon isn't the only one using the term loosely or to mean basically anything short of a full sterotomy. So now I'm still left wondering exactly what he meant.
I guess I've got some time yet, and haven't decided whether to seek another opinion.

By all means, ask him what he meant. Contact his office.

 

[Nancy jane]

Epstns. Thx. You are my " first responder" on this. Am verrrry new & trying to figure it all out. Got the ipad& iPhone down twitter & linked in so I think I can get this. This forum is great
Belies my aorta valve replacement will be early 2012. Interviewing docs this week & learning whether I'll oink or moo ! . Thanks for your comment. Hope u get this. Nancy Jane

 

[Nancy jane]

I'm down to the choice of 2 excellent physicians in St louis Anyone hv St louis connections ? I need to learn how to start a " thread" I guess. Thx. Nancy Jane.

 

[Lynlw]

I'm down to the choice of 2 excellent physicians in St louis Anyone hv St louis connections ? I need to learn how to start a " thread" I guess. Thx. Nancy Jane.

I can't help with the docs in St Louis, but Im computer impaired and can actually start a thread..so once you know how its easy Pick whatever "forum" you want to start a thread in like Pre surgery, and open it, pretty much at the top says "post new thread' in a blue (blue on my comuter at least) rectangle box Just click on that