The technical details of robotic-assisted mitral valve replacement

Abstract

Mitral valve replacement is a method in patients with severe valve disease who have no chance of valve repair. The advantages of minimally invasive techniques during mitral valve operations have been demonstrated in many studies. Robotic assisted surgery is the technological ultimate in minimally invasive surgery and provides a minimal surgical trauma for the patients and a better surgical exposure for the surgeon. The dexterity of robotic instruments with the capacity of high degree rotation mimics surgeon wrist. The endoscope can get very close to the surgical field and the mitral valve, and with its zoom in and out features, it provides more control of the sub-valve structures than conventional surgery. The robotic left atrial retractor assists the surgeon not only in left atrium but also at many points. Thanks to this feature, the robotic left atrial retractor is different and useful from the conventional minimally invasive retractors.Robot also helps surgeon to suppress tremors during reconstruction. All these factors may assure a more effective and safer mitral valve repair/replacement with robotic surgery. The adoption of robotic techniques was quite slowly in cardiac surgery comparing to other specialities. This might be related to cost, longer learning curve, and the necessity of a large team with patience, perseverance and dedication. In this section, the technical details of robotic assisted mitral valve replacement will be presented and enriched with video images. Some tips in the article may help surgical teams who are new to robotic surgery to perform a safer and faster surgery.