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Updated: Sep 24, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Technical tips in non-robotic endoscopic mitral valve surgery: How to approach and expose the mitral valve
Minoru Tabata1,2,3, Ryota Nakamura1, Suguru Tatsuki2
1Department of Cardiovascular Surgery, 38507Tokyo Bay Urayasu Ichikawa Medical Center, Japan.
Abstract:
The non-robotic endoscopic mitral valve surgery is performed via a right mini-thoracotomy without the use of rib spreader or robotic assistance. Although it has several advantages over the direct vision minimally invasive and robotic approaches, operating in very limited working space without robotic assistance is technically demanding. In the first place, it is impossible to perform non-robotic endoscopic mitral valve surgery safely and efficiently without knowing how to approach and expose the mitral valve in very limited working space without robotic assistance. This manuscript introduces detailed technical tips for efficient approach and uncompromised exposure of the mitral valve in non-robotic endoscopic mitral valve surgery, including separate bicaval cannulation, decentralized positioning of the instruments, controlling the direction of traction sutures and appropriate use of retractors.
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