Talking with Asst. Prof. Dr. Siam Khacharoen, cardiothoracic surgeon, Ramathibodi Hospital, on the day of small-incision heart surgery. It is a new choice for patients.

When talking about heart surgery I believe that many people are afraid and do not want to do it, even for heart patients who need surgery themselves. This is because traditional heart surgery is a large surgery that requires the breastbone to be cut apart. As a result, after surgery Patients often experience long periods of pain, long recovery times, and are left with a large scar nearly 20 centimeters across the center of their chest.

But today, technology is more advanced. has made heart surgery no longer so scary Because there is a technique called “Minimal Incision Heart Surgery” It is another option that will make the patient heal faster. Recover faster than before And can return to normal life such as working, driving, exercising, traveling, etc. in a short period of time. Or it can be said that Patients will have a better overall quality of life.

What would this type of heart surgery look like? What is the same or different from traditional surgery? Today, the TODAY news agency will take everyone to find the answer together. Through talking with Asst.Prof.Dr.Siam Khacharoen, Cardiothoracic Surgeon, Ramathibodi Hospital One of Thailand’s specialists in minimally invasive heart surgery.

Heart surgeon I started my career because I wanted to help reduce the number of patients.

Before going on to talk about minimally invasive heart surgery. We started our conversation with Acharn Siam with a simple question. Why did you choose to study further? and works as a cardiothoracic surgeon. So that readers can see the overall situation of medical specialties. Including the treatment of heart patients in that era Because we know that over the past several decades ‘Cardiac and thoracic surgery’ is a field in which very few doctors graduate. But at the same time, it is a branch where there are quite a number of patients waiting to receive treatment.

Achan Siam or Dr. Siam said that he came to study cardiothoracic surgery. at the Faculty of Medicine Ramathibodi Hospital Mahidol University Because I am a person who likes manual work. Moreover, at that time (2002) it was a time when there were very few heart surgeons in Thailand. In one generation, the whole country There will only be about 5 doctors graduating, but there are a lot of heart patients. So I thought that studying this field would be most beneficial.

“After graduating with a specialty in cardiac surgery (2007), I had the opportunity to work at the Queen Sirikit Heart Center, Khon Kaen University, because there were still few specialized doctors in the Isan region. There are also few heart centers in the region. But there are a lot of patients. Even though nearly a thousand surgeries are performed per year, there is still a waiting list for another year and a half. So I chose to go there first. Then after working for a while I’ve gathered enough experience. then moved back to Ramathibodi Hospital.”

Differences in heart disease patients in the central and northeastern regions

From experience working in both the central and northeastern regions for more than ten years. This allows the doctor to clearly see the differences between patients in these two regions, saying:

“The number of cases at Rama Hospital There are a lot less than in the Northeastern region. Because in Bangkok there is a medical school. and many hospitals that can perform heart surgery But the characteristics of patients in Bangkok are different from those in the Northeast, which is that they are older. Most of them are elderly people. with many congenital diseases It turns out that the number of cases here has decreased. But the difficulty of the case increased than before. Including the expectations of patients in Bangkok are quite higher than those in other provinces. Because he came to Rama Hospital Because we hope to receive the best service. The newest technology and the best treatment results.”

Today’s patients want surgery that involves small incisions, little pain, and quick recovery.

The doctor further explained the patient’s expectations. Heart disease patients who come for treatment at Ramathibodi Hospital Want to receive the best treatment With the most modern technology And the important thing is to consider the beauty of the surgical wound as well.

Due to traditional surgery or standard surgery Even though it is very safe. and can cure everything But it caused the patient to have a long wound from the pharynx to the epigastrium. Because there must be a saw to cut the breast bone. To create an opening for the doctor to reach in and use a large instrument to touch the heart. which is enough for a big wound What will follow is The patient will lose more blood. Postoperative pain will be high. Recovery to return to full daily life takes a long time. Because you have to wait for the breast bones to fuse together completely. This may take up to 3 months.

“Many patients, when they see people telling people that heart surgery hurts a lot, takes a long time to recover, and has big wounds, they are afraid of surgery. And when he was afraid of surgery It will become that he will have slower access to treatment. Wait until there are many diseases. I really couldn’t take it anymore so I had to come in for surgery. The results of the treatment would not be as good as those of people who were just sick.”

With an understanding of the needs of patients in this era The doctor therefore looked for a new treatment technique, which is “minimally invasive heart surgery” by going on many study tours abroad. and collect various techniques to be applied to treatment at Ramathibodi Hospital

“Small Incision Heart Surgery” and creating a good quality of life for patients

The doctor gave additional information: Heart surgery is a small incision. The size of the wound can be reduced from 20 centimeters to only 4-5 centimeters. The wound will be under the right breast. It’s not in the middle of the chest like traditional surgical methods. Because there is no need to have surgery on the sternum But it still gives the same good treatment results.

“Today’s technology allows us to operate with small incisions. With various tools such as video cameras and surgical tools specifically designed for small incision surgery. It is therefore an option that I believe will allow patients to access treatment faster. Overall treatment results will be better. and have a better quality of life.”

“I am lucky that Ramathibodi is a medical school that is open to technology. There is high flexibility in this aspect. Enabling all surgeons to use new technology Can be treated Under conditions of maximum patient safety This is a good opportunity for me to get to know you. and chose to learn minimally invasive heart surgery Because it is seen that it will be a trend in the future that will cause less pain for patients. recover faster Get more benefits And the hidden benefits that follow are When the patient recovers quickly The hospital stay will be shortened. That means that the beds at Rama Hospital limited It will turn the bed more quickly. It is said to answer the overall needs of the entire country, patients, and our own institution.”

The doctor explained that heart surgery involves small incisions. It is surgery through the ribcage. and brought in a telescope To help make it easier to see inside Longer surgical equipment will be used. more accurate High strength and is specially designed So that the doctor can perform heart surgery through a small opening by GEISTER Medizintechnik GmbH from Germany Which is imported and distributed by Summit Healthcare Company Limited. It is another tool that doctors and medical teams in the operating room trust to use in small incision surgery.

By this kind of surgery It will reduce the patient’s recovery time in the hospital, namely spending 2 nights in the ICU and resting in the hospital for only 4-7 days, then returning home to live a normal life. But still must refrain from lifting heavy things. But if a month and a half or 6 weeks have passed, the muscles are completely connected together. Patients can now exercise. But if it is heart surgery using traditional methods Patients may need to recuperate for up to 12 weeks before their body returns to normal.

In addition, the doctor gave an example of a patient undergoing surgery that showed that Minimally invasive heart surgery helps patients recover quickly. and have a good quality of life

“In young patients We will not be able to see the differences very clearly. Because he can tolerate pain well. But the results will be clearly seen with elderly patients aged 70-80 years and over. I have performed small-incision heart surgery on my oldest patient, who was 89 years old. Normally, if the patient is this age and has many congenital diseases, Then had to encounter traditional surgery You’ll probably have to stay in the hospital for 2-3 weeks to recover. You can go back and help yourself. To the point that some people may become bedridden. muscle weakness There are other complications that follow. But after having surgery with a small wound Turns out he was a little hurt, got up and started walking quickly, recovered after 6 days and was able to go home. Various muscles do not atrophy or atrophy. Just 1 week after surgery, the patient climbs into bed by himself. Let us check right away without having to have relatives support us.

Or like a young patient, about 18-19 years old, 5 days after surgery, they can go home and return 1 week later for a follow-up examination. He said that he had already taken the midterm exam and it was fine. In less than 10 days after surgery the patient was able to recover and go back to take the exam. If it is a traditional surgical wound He might have to drop out for one semester.”

Small wounds come with challenges

But the patient will have a smaller surgical wound. and go back to living life as desired like this Surgeons have to overcome many challenges. in learning and developing skills

“Small incision surgery techniques require a lot of time to learn and practice. When I just started doing it. It will be more time consuming than standard surgery. Because it requires skills in looking at the screen and doing it with your hands, it’s like playing a computer game. But if we can get past this point We will do new procedures. And you can learn more new things. It’s like a gasoline car and an electric car. That change is often limited in the beginning. But in the end Technology will develop to make small incision surgery better and better. and patients will receive more benefits,” the doctor said.

Recover quickly, but it may not be suitable for everyone.

Although heart surgery involves small incisions There will be many good results, but not everyone can choose to receive this treatment. Because the surgeon who owns the fever Many factors must be considered in making recommendations.

“The doctor will mainly look at the patient’s underlying disease. That is, if 1-2 heart valves are narrowed or leaking, surgery with small incisions will have a higher chance of being possible. But what if people have other co-morbidities such as coronary artery disease, 3-4 valves damaged or need to have their aorta replaced? It may not be possible to make a small wound. Therefore, the doctor will have a thorough examination of the patient. Including x-rays, echo, cardiac catheterization, and dye injections to look at the coronary arteries. To evaluate that patient Is it suitable for small incision surgery? If it’s suitable, we do it. But if it’s not suitable We will tell the patient directly. and recommended surgery using traditional methods instead.”

Each year, there are no more than 300 small-incision heart surgery cases/year, or approximately 5% of all heart surgeries. Ramathibodi Hospital is the top medical institution that performs minimally invasive heart surgery in Thailand.

Is it necessary for heart disease patients to have surgery?

However, the doctor also provided additional information: Not every heart disease patient needs surgery.

“When we talk about heart disease In the language of the common people, it would mean a sudden heart attack. Chest pain, heart attack, and then death. But actually, heart disease has many things. This small incision heart surgery We are talking about narrowed or leaking heart valves. It mostly occurs in people aged 40 years and over because the heart has been working hard for a long time. And there are other risk factors as well, such as high blood pressure, fat in the arteries, etc.”

Therefore, it can be said that not every case of heart disease requires surgery. Some people, if they realize it quickly Come see the doctor quickly. Maybe just take medicine. and adjusting lifestyle habits is enough So if you find yourself getting tired more easily, palpitations, irregular heartbeat, dizziness, fainting, or being unable to lie down. until affecting daily life You should see a doctor as soon as possible. in order to have a thorough health check Treat in a timely manner and reduce the severity of the disease so that it does not require surgery

All of these are interesting stories of small-incision heart surgery through the perspective and experience of Asst. Prof. Dr. Siam Khacharoen, a cardiothoracic surgeon at Ramathibodi Hospital, one of Thailand’s experts in small-incision heart surgery.

TODAY news agency hopes that this discussion It will make many people less afraid of heart surgery. and dare to receive treatment or take family members to receive treatment in a timely manner Because of letting the illness go on for too long This will increase the risk of surgery.