[Differences between Minimary Invasive Cardiac Surgery and Robot-assisted Cardiac Surgery in Mitral Valve Repair].

It has been more than 10 years since the introduction of small-incision surgery for cardiac valvular disease. The so-called minimally invasive cardiac surgery (MICS) techniques avoid the need for sternotomy, but they are still not considered standard approaches. We started performing MICS at our hospital in October 2010, and we started performing robot-assisted cardiac surgery in June 2019 while undergoing a transition from direct vision to complete endoscopic surgery. We performed a total of 81 cardiac procedures between June 2019 and December 2021;78 of these included mitral valve repair. Because robot-assisted cardiac surgery is an extension of MICS, it is essential to establish safe MICS procedures before introducing robot-assisted cardiac surgery to an institution. We will review and report the results of these procedures at our hospital, including MICS and plastic procedures performed as preparation for the introduction of robot-assisted cardiac surgery. We will also describe changes and ingenuity in robot-assisted cardiac surgery procedures after introduction.