“…[9][10][11] Minimally invasive thoracoscopic techniques, although preferable to open surgery, are still traumatic in that the left lung must be deflated, the beating heart must be stabilized, and rigid tool shafts are often used which limits the reachable workspace, all of which limit the safety and efficacy of gene therapy delivery by such means. 9,12 More recently, robotic minimally invasive surgery has become a popular option, 13 often enabling improved access and repeatability, 11,14 but the heartbeat remains a major challenge. 13,15,16 Another robotic system for beating-heart surgery is HeartPrinter (previously referred to as Cerberus), a flexible parallel wire robot developed for minimally invasive gene therapy injections from an epicardial vantage.…”