Robotically assisted cardiac surgery: minimally invasive techniques to totally endoscopic heart surgery.

Over the past decade, advancements in cardiac surgery occurred secondary to improvements in technology and the desire for a less invasive approach to operations in general. Minimally invasive cardiac surgery has progressed from partial sternotomy incisions to totally endoscopic open-heart procedures with robotic-assistance. There are 2 major companies that produce robotic equipment for use in cardiac surgery. These companies must undergo Food and Drug Association (FDA) mandated clinical trials on each cardiac surgical procedure, before it can be approved for public use. The surgeon must demonstrate clinical proficiency to operate the robotic equipment per FDA approved company testing. The use of computer (robotic) enhancement is well documented for coronary artery bypass grafting and selected cardiac valve procedures. Recent advancements are now being directed at congenital heart disease. The use of robotic-assisted totally endoscopic atrial septal defect closure is a tremendous advancement in congenital cardiac surgery. The future of robotic cardiac surgery will hopefully expand to cover more advanced valve procedures, congenital heart defects, and other procedures once robots are further modified for pediatric use.