For many patients, the prospect of undergoing an operation brings more questions about pain, recovery, complications, and how quickly they can return to their routines. The same fears can influence how patients approach treatment, particularly when surgery becomes necessary.
Prof. Theodoros Kofidis, a cardiothoracic surgeon at Mount Elizabeth Hospital in Singapore, said advances in surgical techniques have changed patient experience by allowing surgeons to perform selected heart procedures without opening the breastbone.
Prof. Kofidis has spent nearly two decades working with minimally invasive heart surgery. The approach has become a major part of his work, and his team has established a comprehensive program at Mount Elizabeth Orchard that combines minimally invasive surgical techniques with protocols covering preparation before surgery, care during the operation, recovery, and rehabilitation.
“Minimally invasive means that we don’t split the chest bone and save the patient a lot of trouble in the process of his recovery,” he told BusinessWorld. “Patients [today] and in the future no longer need to worry about a very troublesome and traumatic experience. The patient journey is entirely changing.”
Instead of opening the sternum, surgeons can reach the heart through small openings between the ribs. The approach can be used for selected procedures involving the mitral valve, aortic valve, and coronary artery disease requiring bypass surgery.
Such difference can affect the patient’s recovery after the operation. As the sternum remains intact, patients can mobilize and move more freely, with fewer restrictions after discharge.
The technique also changes how patients perceive the experience of heart surgery, particularly for people who associate the procedure with severe pain, prolonged hospitalization, or an extended period of disability.
The combination of minimally invasive surgery and fast-track protocols has allowed his team to shorten parts of the recovery process. In some cases, patients can be awakened and extubated in the operating theater, begin walking the following day, and leave the hospital within a few days.
However, Prof. Kofidis noted that the technique does not replace conventional surgery for every patient. Some high-risk or highly complex cases still require a traditional sternotomy, making patient selection and a careful assessment of each case an important part of the treatment process.
“We welcome patients to discuss what is best for them, and we adapt the best possible procedure. Basically, we personalize the surgery for them to achieve the best possible outcome,” he explained.
Guiding patients’ decisions
While surgical technology has changed, Prof. Kofidis said fear remains one of the reasons patients hesitate to seek treatment.
He acknowledged that surgery is something people naturally fear, but argued that perceptions of heart surgery can sometimes be shaped by experiences and images associated with earlier generations of cardiac procedures.
“[Heart surgery] is not the same as it was 30 years ago,” he said. “With minimally invasive techniques and new technology platforms, we give the patient a totally different perception and help the patient manage the anxiety of the surgery.”
Prof. Kofidis also pointed to the importance of protocols that begin before surgery and extend through recovery and rehabilitation. The patient journey, he shared, involves cardiologists, surgeons, nurses, and other health professionals who contribute to decisions and care at different stages.
“An effective heart team is based upon guidelines, mutual trust, and the best interest of the patient,” he noted. “We communicate, and we make the best possible decision in the very best interest of the patient.”
Prof. Kofidis also explained that his decision to practice at Mount Elizabeth Hospital after spending four decades in institutions across three continents was influenced by the hospital’s adaptable environment.
“In 40 years of career and training in some of the strongest institutions in the world, I chose to make Mount Elizabeth Hospital my home,” he said. “I found a very fertile ground to grow a new platform and adapt new techniques and technologies.”
He credited the hospital’s leadership and staff for supporting the adoption of new techniques and technologies. He also cited the skills of its operating theater and intensive care unit medical practitioners, whom he described as among the best-trained he has encountered during his work.
For him, the operation requires coordination among health professionals, as each contributes to the patient’s care, from preparation through surgery and recovery.
“It’s about the teamwork; it’s about the level of all the healthcare professionals that are involved in this journey,” he concluded.
For inquiries, please contact Mount Elizabeth Hospital’s patient assistance center, IHH Healthcare Singapore — Philippine Office, located at G/F-B, Marco Polo Hotel, Meralco Avenue and Sapphire Street, Ortigas Center, Pasig City 1600; e-mail manila.ph@ihhhealthcare.com; or call 0917-526-7576.
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