New techniques in heart surgery have allowed many common open-heart operations to be performed through smaller and less traumatic incisions. Since 1994 Cedars-Sinai Medical Center has been performing operations on infants, children and adults using these techniques, making recovery much easier for the patient.

Cedars-Sinai Medical Center was the first to establish a minimally invasive heart surgery program for children west of the Mississippi and has the most extensive experience in the region. Using techniques that make less of an impact on a young patient's body has often resulted in early discharge from the hospital and a speedy return to normal childhood activities. Limited incisions lower the risk of long-term complications in children without affecting treatment of the underlying heart disease.

Among the many innovations used at Cedars-Sinai for advanced minimally invasive surgery is the robotic surgical system. This system improves a surgeon's ability to perform complex minimally invasive surgery and makes possible microsurgical procedures that conventional surgical procedures cannot achieve.

The system consists of three robotic arms, one to position the endoscope and two to hold surgical instruments. The surgeon can precisely control the surgical instruments with his hands while the positioning of the endoscope is voice controlled. A video display of the endoscopic image allows the surgeon to see inside the patient's body. This system improves the surgeon's precision and ability to manipulate instruments in small spaces, helping to make the procedures even less invasive.

Valve replacement and heart artery bypass can be performed through small incisions and do not require cutting into the breastbone (sternum). These operations are performed at low risk and do not affect the treatment of the underlying heart disease.

Another minimally invasive procedure used at the Cedars-Sinai Heart Institute is transmyocardial laser revascularization (TMLR). This minimally invasive procedure is performed on patients with end-stage heart disease. The physician uses a laser beam to stimulate new blood vessel growth in the heart.

Cedars-Sinai Medical Center was the first in the southwestern United States to use this revolutionary technology and has been involved in many national research studies to determine its usefulness. TMLR can be used alone or with a coronary bypass in patients who are not candidates for angioplasty or bypass surgery alone and who have severe angina (chest pain).

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that uses small incisions and eliminates the need to spread the ribs. VATS is performed through a one-inch incision and is aided by a miniature camera inserted through one of the three quarter- to half-inch incisions. The VATS approach is certainly not painless, but it does hurt less than a large thoracotomy. The average hospitalization after the operation is four days, and patients usually do not require a stay in the intensive care unit.