Beyond the Incision: Robotic Heart and Thoracic Surgery with
Asst. Prof. Dr. Boonlawat Homvises Asst. Prof. Boonlawat Homvises, M.D., is a cardiothoracic surgeon specializing in minimally invasive cardiac surgery, thoracic surgery, heart and lung transplantation, ECMO, and mechanical circulatory support. His international experience includes a clinical fellowship at Papworth Hospital in Cambridge, UK, specialized training in the da Vinci Xi surgical system and robotic thoracic procedures in Singapore, and intensive training in cardiac surgery in Chicago, USA. At Bumrungrad International Hospital, he led the team performing Thailand’s first robotic-assisted MIDCAB procedure at a private hospital.
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What does this mean for patients undergoing MIDCAB?
How does the da Vinci Xi change heart bypass surgery?
The key difference is that we usually do not need to divide the breastbone. The procedure uses small ports and a limited incision between the ribs. In selected patients, surgery can be performed while the heart continues beating, often without a heart-lung machine. This may mean less surgical trauma, less postoperative discomfort, earlier mobility and faster recovery.
In robotic-assisted MIDCAB, the da Vinci X i allows us to work inside the chest through small ports with a magnified 3D view and highly flexible instruments. We can carefully prepare the left internal mammary artery, or LIMA, and connect it to the left anterior descending artery, or LAD, to restore blood flow. The system supports precise, controlled movement around delicate cardiac structures.
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Which thoracic conditions may benefit from robotic surgery? Robotic-assisted surgery may be considered for selected patients with lung cancer, thymoma, mediastinal tumors, esophageal disease and certain pleural conditions. Depending on the procedure, potential benefits can include smaller incisions, less chest-wall disruption, reduced postoperative discomfort and faster recovery. The best approach depends on the disease, its location and complexity, previous surgery and the patient’s overall health.
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Why is robotic technology useful in thoracic surgery?
Thoracic surgery often requires surgeons to work around the lungs, blood vessels, nerves and other important structures within a confined space. The da Vinci Xi provides enhanced visualization and wrist-like instrument movement, helping surgeons perform delicate dissection and suturing with greater control while minimizing disruption to surrounding tissue.
Asst. Prof. Boonlawat Homvises, M.D., Bumrungrad International Hospital
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