Home› MICS Surgery

Minimally Invasive Bypass Surgery
& Keyhole Heart Surgery

Bypass surgery and valve procedures through a 3–7 cm keyhole incision — no chest bone splitting, shorter hospital stay, faster return to life. Available in Kuala Lumpur by Prof. Dr. Shahrul Amry Hashim.

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What Is MICS?

Keyhole Heart Surgery — What It Is and Why It Matters

Minimally Invasive Cardiac Surgery (MICS) — known in Bahasa Malaysia as Pembedahan Jantung Lubang Jarum or Bedah Lubang Jarum — is a surgical approach that allows complex heart operations to be performed through a small keyhole incision between the ribs, rather than cutting through the breastbone (sternotomy).

In traditional open-heart surgery, the sternum (chest bone) must be split — a procedure called a sternotomy — creating a 20–25 cm wound that requires months to fully heal. MICS changes this fundamentally: the surgeon accesses the heart through a carefully placed 3–7 cm incision between the ribs, guided by camera assistance and specialised instruments.

The surgical outcome — whether a bypass graft, a repaired valve, or a closed congenital defect — is the same. The difference is in how the patient experiences recovery: less pain, a much smaller scar, a shorter hospital stay, and a faster return to daily life.

This approach has been standard practice in leading cardiac centres across Germany and Europe for over two decades. Prof. Dr. Shahrul Amry Hashim has championed its introduction and adoption in Malaysia — and today leads one of the most active MICS programmes in private Kuala Lumpur.

Prof. Dr. Shahrul Amry Hashim reviewing MIS CABG cardiac surgery diagrams at his desk at KPJ DSH2, demonstrating minimally invasive bypass surgery techniques
In Bahasa Malaysia
MICS / Minimally Invasive Cardiac Surgery
Pembedahan Jantung Lubang Jarum / Bedah Lubang Jarum

Bypass (CABG)
Pembedahan Bypass Jantung / Bypass Lubang Jarum
Side-by-Side Comparison

Minimally Invasive vs Traditional Open-Heart Surgery

The same cardiac procedure — two very different experiences. Ask Prof. Shahrul whether the keyhole approach is right for your case.

Traditional Approach
Open-Heart Surgery
Prof. Shahrul's Approach
Keyhole (MICS) Surgery
Preferred Where Suitable
✗ 20–25 cm incision (full sternotomy)
✓ 3–7 cm keyhole incision (between ribs)
✗ Chest bone must be split and wired back
✓ No sternotomy — no bone splitting
✗ 7–10 days in hospital
✓ 3–5 days in hospital
✗ ~6 weeks recovery to normal activity
✓ ~2 weeks recovery to normal activity
✗ Significant post-operative pain
✓ Significantly reduced pain
✗ Higher sternal wound infection risk
✓ Lower infection risk
✗ Large, visible scar
✓ Minimal scarring — cosmetic benefit
✗ Longer stay = higher total cost
✓ Shorter stay generally reduces total bill
Eligibility

Who May Be a Candidate for Keyhole Heart Surgery?

Suitability for MICS depends on your individual diagnosis, anatomy, and overall health. Prof. Shahrul assesses each patient's case individually. The following conditions may generally be addressed using a minimally invasive approach.

Coronary Artery Disease

Triple vessel disease (TVD), LAD disease, or multi-vessel coronary artery disease (IHD) requiring bypass surgery (CABG) may be suitable for the keyhole approach.

Valve Disease

Mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, and tricuspid regurgitation may be addressed through minimally invasive valve repair or replacement.

Congenital Heart Defects

Atrial septal defects (ASD), ventricular septal defects (VSD), and coronary fistulas — in both adult and paediatric patients — may be repaired using keyhole techniques.

Lung Conditions

Lung cancer, spontaneous pneumothorax, thymoma, lung metastases, and lung sequestration may be treated using VATS (video-assisted thoracoscopic surgery).

Second Opinion Cases

If you have been told you need open-heart surgery, Prof. Shahrul can assess whether a minimally invasive alternative may be appropriate for your specific case.

Not Sure? Book an Assessment

Every case is different. The only way to know if keyhole surgery is suitable for you is a personalised consultation with Prof. Shahrul.

Book Consultation →
Clinical Programme

Procedures Performed Using MICS at KPJ DSH2

Prof. Shahrul's MICS programme at KPJ Damansara Specialist Hospital 2 covers a broad range of cardiac and thoracic procedures.

1. Minimally Invasive Bypass Surgery (MICS CABG)

The flagship procedure. Using a 3–7 cm keyhole incision between the ribs — no sternotomy (no chest bone splitting) — Prof. Shahrul performs coronary artery bypass grafting (CABG) to reroute blood flow around blocked coronary arteries. This is one of the most technically demanding procedures in cardiac surgery, and Prof. Shahrul actively performs MICS CABG with published research supporting the approach.

Triple Vessel Disease (TVD)
LAD Disease / Single-Vessel CABG
Multi-Vessel Coronary Artery Disease (IHD)
Combined CABG + Valve Procedures

2. Minimally Invasive Valve Surgery

All major valve procedures — repair and replacement — can be performed through a keyhole incision. Valve repair is generally preferred over replacement where anatomically feasible, preserving the patient's natural tissue and reducing the need for long-term anticoagulation.

Mitral Valve Repair (MIS Mitral Repair)
Mitral Valve Replacement (MIS MVR)
Aortic Valve Replacement (MIS AVR)
Tricuspid Valve Repair (MIS Tricuspid)
Combined CABG + Valve Procedures
MAZE Procedure (for Atrial Fibrillation)
Left Atrial Appendage Ligation
MVR + TAP MAZE (Combined)

3. Minimally Invasive Congenital Heart Surgery

Congenital heart defects — including hole-in-the-heart conditions — can be addressed using keyhole techniques in both adult and paediatric patients, avoiding the need for open-chest surgery.

ASD Closure (including Sinus Venosus ASD)
VSD Repair
Coronary Fistula Ligation
Adult Congenital Procedures

4. Minimally Invasive Lung Surgery (VATS)

Video-assisted thoracoscopic surgery (VATS) — Pembedahan Paru-Paru Lubang Jarum — allows lung procedures to be performed through small keyhole incisions using a miniature camera. This minimally invasive approach to thoracic surgery typically results in faster recovery and less post-operative pain than open thoracotomy.

VATS Lobectomy (lung cancer, lung sequestration)
VATS Bullectomy & Pleurectomy (pneumothorax)
VATS Thymectomy (thymoma)
Metastasectomy (lung metastases)

5. Complex & Emergency Cardiac Surgery

For patients requiring high-complexity or emergency cardiac surgery, Prof. Shahrul and the DSH2 Heart & Lung Centre provide a comprehensive surgical programme covering redo and emergency cases.

Redo CABG
Bentall Procedure (aortic valve + root)
Emergency Ascending Aorta Replacement
Hemiarch Aorta Replacement
ECMO Decannulation
Complex Combined Valve Procedures
What to Expect

The Keyhole Surgery Journey — Step by Step

From your first consultation to full recovery, here is what the MICS process typically involves.

1
Initial Consultation
Prof. Shahrul reviews your existing cardiac reports, angiogram, and echocardiogram. He discusses your diagnosis, surgical options, and assesses whether MICS is appropriate for your specific anatomy and condition.
2
Pre-Operative Assessment
Full pre-operative workup at DSH2 — including blood tests, renal function, cardiac imaging, anaesthesia review, and any additional investigations required. DSH2's Hybrid Cath Lab and advanced imaging capabilities support comprehensive pre-surgical planning.
3
Surgery (Operating Theatre)
The procedure is performed in DSH2's state-of-the-art Digital Operating Theatre under general anaesthesia. A 3–7 cm incision is made between the ribs. The heart procedure is performed precisely using specialised instruments, without splitting the sternum.
4
ICU Recovery
Patients typically spend 1–2 days in DSH2's Intensive Care Unit (10 ICU beds), under close monitoring by the cardiothoracic team before transfer to the ward.
5
Hospital Discharge
Most MICS patients are discharged within 3–5 days of surgery — significantly shorter than the 7–10 days typical after open-heart surgery.
6
Recovery at Home
Most patients return to light normal activities within approximately 2 weeks. Prof. Shahrul's team coordinates with your referring cardiologist for shared post-operative follow-up care.
Hospital Technology

Advanced Technology at KPJ DSH2

KPJ Damansara Specialist Hospital 2 is equipped with state-of-the-art technology designed to support minimally invasive cardiac and thoracic surgery.

Hybrid Cath Lab

Biplane angiography capabilities allowing complex cardiac imaging and hybrid procedures combining interventional cardiology and cardiac surgery in a single setting.

Da Vinci Xi Surgical Robot

The Da Vinci Xi robotic surgical system supports precision minimally invasive procedures with enhanced 3D visualisation and multi-joint instrument control.

Digital Operating Theatres

7 state-of-the-art Digital Operating Theatres with integrated advanced imaging, lighting, and surgical systems — designed for complex cardiac and thoracic procedures.

Cardiac ICU (10 Beds)

Dedicated 10-bed Intensive Care Unit for post-operative cardiac monitoring, staffed by a specialist multidisciplinary team with 24-hour consultant cover.

Mayo Clinic Care Network

DSH2 is the first hospital in Malaysia admitted to the Mayo Clinic Care Network — providing access to Mayo Clinic expertise, protocols, and knowledge-sharing resources.

JCI Accreditation

Joint Commission International (JCI) accreditation — the gold standard of international healthcare quality and patient safety, ensuring the highest standards of clinical care.

Expert Assessment

Not Sure If You Need Surgery?

If you have been told you require open-heart surgery and would like to explore whether a minimally invasive approach is possible, Prof. Shahrul offers expert second opinion consultations. He will review your existing reports, angiogram, and imaging — and give you a clear, honest assessment of all your surgical options.

Book a Second Opinion Referring a Patient?
Common Questions

Patient FAQ — Minimally Invasive Heart Surgery

Book Your Assessment

Find Out If Keyhole Heart Surgery Is Right for You

Book a consultation with Prof. Dr. Shahrul Amry Hashim. Bring any existing cardiac reports, angiogram results, or echocardiogram imaging. Consultations available within days.

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