A New Path to Heart Surgery: Robotic-Assisted MIDCAB and Valve Surgery For selected patients with coronary artery disease, heart bypass surgery may no longer require opening the breastbone. Robotic-assisted minimally invasive direct coronary artery bypass, or robotic-assisted MIDCAB, uses small chest incisions to restore blood flow to the heart while reducing the surgical access required. Bumrungrad International Hospital performed the first robotic-assisted MIDCAB procedure at a private hospital in Thailand, led by Asst. Prof. Boonlawat Homvises, M.D., a cardiothoracic surgeon with expertise in minimally invasive cardiac surgery.
How Does Robotic-Assisted MIDCAB Work? Robotic-assisted MIDCAB is most commonly considered when the left anterior descending coronary artery (LAD) is significantly narrowed or blocked. The surgeon uses robotic-assisted instruments to prepare the left internal mammary artery (LIMA). Through a small incision between the ribs, the LIMA is connected to the LAD beyond the blockage, creating a new pathway for blood flow. The robot does not operate independently. Every movement is controlled by the surgeon from a specialized console, supported by magnified three-dimensional visualization and highly flexible instruments.
Potential Benefits Compared with Open-Heart Surgery For appropriately selected patients, robotic-assisted MIDCAB may offer:
Small ports and a 4-6 cm incision between the ribs No need to divide the breastbone, reducing risks related to breastbone healing Less surgical trauma and potentially less blood loss Usually no need for a heart-lung machine Less discomfort during early recovery Potentially shorter hospital stay Faster recovery and return to daily activities
MIDCAB Surgery
Beyond Bypass: Minimally Invasive Valve Surgery
Minimally invasive techniques are also expanding options for heart valve surgery. For selected patients, surgeons may repair or replace a heart valve through smaller chest incisions instead of a traditional open-heart approach. In some cases, catheter-based procedures may offer another option without opening the chest. The most suitable treatment depends on the affected valve, the severity of disease, overall health, anatomy, and the individual patient’s surgical risk and treatment goals.
Heart Bypass Sugery
At Bumrungrad, multidisciplinary cardiac teams evaluate coronary artery and heart valve disease to determine whether robotic-assisted, conventional surgery, catheter-based treatment, or another approach is most appropriate for each patient.
Bumrungrad Robotic Surgery Center
8 Issue: September 2026
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