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Beyond Surgical Access: Evidence Supporting a Multidimensional Concept of Surgical Invasiveness in Contemporary
Salvatore Poddi1, Alessio Rungatscher1
1Division of Cardiac Surgery, University of Verona Medical Center, 37126 Verona, Italy.
Journal of Cardiovascular Development and Disease
|July 27, 2026
Summary
Minimally Invasive Cardiac Surgery (MICS) definitions need updating. Beyond incision size, MICS invasiveness includes physiological impact and patient recovery, requiring a multidimensional assessment.
Area of Science:
- Cardiac Surgery
- Surgical Innovation
- Patient-Centered Care
Background:
- Traditional Minimally Invasive Cardiac Surgery (MICS) definitions focus on surgical access and incision size.
- Technological advancements like robotics and enhanced perioperative care challenge these narrow definitions.
- Patient impact extends beyond surgical exposure, encompassing physiological and recovery dimensions.
Purpose of the Study:
- To discuss the contemporary meaning of invasiveness in cardiac surgery.
- To examine limitations of conventional MICS definitions.
- To propose a multidimensional interpretation of MICS.
Main Methods:
- Narrative review based on literature search (PubMed, Scopus, Web of Science).
- Thematic synthesis approach to explore surgical invasiveness.
- Focus on patient-centered outcomes and perioperative burden.
Main Results:
- Conventional MICS definitions based solely on surgical exposure are inadequate.
- Surgical invasiveness is a multidimensional concept.
- Technical, physiological, and recovery factors collectively define MICS.
Conclusions:
- A broader, multidimensional definition of MICS is necessary.
- Invasiveness assessment must incorporate patient-centered outcomes and perioperative burden.
- Future MICS evaluation should consider technical, physiological, and recovery aspects.
