High speed robotic mitral valve repair

Robotically-assisted mitral valve surgery is a safe, effective procedure, and excellent outcomes are reasonably expected.The first robotic mitral valve repair was performed in 1998 in Europe using an early prototype of the da Vinci Surgical System and in 2000 in North America.The advantages are smaller, less invasive incisions, less pain, shorter hospital stays, better appearance, faster return to preoperative functional activity levels, and reduced need for blood transfusions.Although advances and developments in procedure and instrumentation have reduced not only operation time but also cardiopulmonary bypass and aortic cross-clamp, robotic surgery still requires more time than a standard sternotomy or thoracotomy.We have organized "robotic heart team", generated new convenient techniques, and refined surgical procedures such as special knot-tying techniques, use of flexible aortic cross-clamp and transthoracic cardioplegic delivery method, a simplified atrial retraction device, chordal replacement with polytetrafluoroethylene (PTFE) loops, continuous suture for the annuloplasty, special suture material.Through ingenuity and teamwork, simple mitral valve repair can now be completed totally endoscopically via only three ports in less than 2 hours of surgery, 1.5 hours of cardiopulmonary bypass, and 1 hour of aortic cross-clamp without blood transfusion.Here, we explain the way we developed our robotic mitral valve surgery.