A single-port robotic platform for minimally invasive cardiac surgery: system functionality and initial preclinical...

Conventional robotic cardiac approaches generally require multiple intercostal access sites to establish instrument triangulation. This study presents an in-house-developed single-port robotic platform designed around cardiac manipulation requirements and evaluates its initial task-specific feasibility in one pig. The system integrates a common entry guide, three-dimensional endoscopic visualization, articulated instruments, and master-slave teleoperation. Robot-assisted internal mammary artery (IMA) dissection was performed on the beating heart through retractor-assisted intercostal access. Mitral annular suture placement was performed after planned terminal euthanasia, incision enlargement, and manual atrial exposure maintained with suspension sutures. Cardiopulmonary bypass was not used. A 115-mm IMA segment was skeletonized robotically during a 49-min dissection interval within an 87-min IMA phase, followed by manual clipping and division. No additional robotic port was required, and no macroscopic IMA injury or major bleeding was observed during dissection. Mitral annular suture placement was completed at nine positions in 46 min using coordinated bimanual manipulation. These observations provide preliminary evidence that intrathoracic deployment and distal articulation can support the selected cardiac tasks under the reported conditions. The findings provide a basis for technical refinement and further preclinical evaluation but do not establish reproducibility, procedural safety, or the feasibility of a complete single-port mitral valve procedure.