Rajavithi Hospital has become the first facility under Thailand's Ministry of Public Health to perform minimally invasive, multi-vessel coronary artery bypass surgery with robotic assistance, the hospital announced this week. The procedure, known as robotic internal mammary artery harvest with total coronary revascularisation via anterior thoracotomy, can bypass up to four coronary arteries in a single operation through a small chest incision, rather than the 20 to 25 centimeter opening through the breastbone required in conventional open-heart surgery.
Dr Weerawut Imsamran, director-general of the Department of Medical Services, said Rajavithi is the department's leading institution in robotic surgery and the first government hospital to pioneer the technology. The hospital has now performed more than 1,600 robotic-assisted operations in total, spanning general, thoracic and now complex cardiac procedures.
Closing the Gap Between Public and Private Robotic Surgery
Robotic cardiac surgery has typically concentrated in private hospitals and wealthier health systems, where the capital cost of a surgical robot and the training required to operate it are easier to absorb. A government hospital reaching multi-vessel robotic bypass capability signals that Thailand's public health system is narrowing that gap rather than leaving robotic cardiac care as a premium option reserved for patients who can pay out of pocket.
The clinical case for the shift is straightforward: smaller incisions generally mean less blood loss, lower infection risk and faster return to normal activity than sternotomy, the standard open-heart approach. For bypass patients, who are often older and managing other chronic conditions, a shorter recovery reduces the secondary risks tied to prolonged hospital stays, including blood clots and hospital-acquired infections.
Part of a Broader Regional Buildout
The milestone fits a wider pattern across Southeast Asian healthcare systems investing in robotic surgical capacity, from Singapore's hospitals adding multi-port endoscopic platforms to regional governments subsidizing robotic procedures for specific conditions to improve access. Thailand has moved in parallel, with its government previously signaling plans to extend robot-assisted surgery, and free coverage for select cancer procedures, to more public hospitals beyond flagship centers in Bangkok.
Rajavithi's cardiac program builds directly on experience gained from more than 60 robot-assisted lung procedures performed since 2023, suggesting the hospital treated thoracic surgery as a proving ground before advancing to the technically harder territory of beating-heart bypass work. That staged approach, building proficiency in one surgical specialty before extending the platform to another, is a more conservative rollout than some private systems attempt, where a single robot purchase is often marketed across multiple departments immediately.
The bigger test for Thailand's public system will be scale: whether Rajavithi's results can be replicated at other Ministry of Public Health hospitals without the concentration of specialist surgeons and capital investment that made this first case possible in Bangkok.