Computer-enhanced telemanipulation in mitral valve repair: preliminary experience in Canada with the da Vinci robotic system.

BACKGROUND Investigation into the surgical application of robot technology continues to expand. We report on the first case series of robotic-assisted mitral valve (RAMV) repair in Canada with use of the da Vinci telemanipulation system (Intuitive Surgical, Sunnyvale, Calif.). METHODS Between February 2004 and August 2004, 10 patients with normal left ventricular function and severe mitral valve regurgitation underwent RAMV repair with use of the da Vinci system. Peripheral cardiopulmonary bypass, transthoracic aortic cross-clamping and antegrade cardioplegia were used in all cases. A minithoracotomy in the fourth intercostal space and 2 ports in the third and fifth intercostal spaces allowed surgical access. All mitral valve valvuloplasties and band annuloplasties were done endoscopically with robotic assistance. RESULTS Nine of 10 patients had successful valve repair, and 1 had conversion to mitral valve replacement due to persistent regurgitation. There were no deaths, strokes or need for sternotomy. One patient required re-exploration for bleeding. CONCLUSION Minimally invasive RAMV repair is feasible and safe with promising early postoperative results when performed by experienced surgical personnel accomplished in both mitral valve procedures and robotic techniques.