Video-atlas on robotically assisted mitral valve surgery.

Abstract

Mitral valve surgery is the most commonly performed robotically-assisted cardiac surgical procedure. The robotic approach evolved from minimally invasive mitral valve surgery, which was performed via right mini-anterolateral thoracotomy either under direct vision or with endoscopic visualization. The da VinciTM Surgical System (Intuitive Surgical Inc., Sunnydale, CA) has been used in several robotic cardiac surgical centers to successfully perform mitral valve surgery. This system uses high-definition three-dimensional camera imaging and EndowristTM (Intuitive Surgical, Sunnydale, CA) instruments, which allow for motion in six degrees of freedom. When compared with minimally invasive mitral valve surgery, the robotic-assisted approach enables unparalleled visualization of the mitral valve apparatus, tremor-free movements, ambidexterity, and avoidance of the fulcrum effect of using long-shafted endoscopic instruments. The 2 to 3 cm lateral working port incision allows for less pain, quicker recovery, and reduced length of stay when compared with sternotomy. This video article provides a detailed description of our current approach to performing complex mitral valve surgery using the da VinciTM system.