Totally endoscopic closure of an atrial septal defect using the da Vinci Surgical System: report of four cases

This report presents four cases of totally endoscopic closure of an atrial septal defect using the da Vinci Surgical System (Intuitive Surgical, Mountain View, CA, USA). The patients were diagnosed with an ostium secundum atrial septal defect and elected to undergo minimally invasive surgery. A cardiopulmonary bypass was established via cannulation of the femoral vessel and jugular vein, and blood cardioplegic arrest was induced using a transthoracic cross-clamp. The mean extracorporeal circulation and cardiac arrest times were 86 +/- 21 and 22 +/- 8 min, respectively. No patient experienced pain after surgery, and all were fast-tracked for early discharge and released on postoperative day 3. No intraoperative or postoperative complications occurred. This procedure permitted a short hospital stay, quick return to an active lifestyle, and had an excellent cosmetic outcome. The success of this procedure therefore encourages that this procedure should be considered as day surgery.