Minimally Invasive and Robotic Valve Procedure

Robotically assisted mitral valve surgery is a minimally invasive heart surgery performed by a cardiac surgeon, on the mitral valve with an endoscopic, closed-chest approach.

Your mitral valve

There are four valves within your heart. They are the mitral, tricuspid, aortic and pulmonic valves. The mitral valve lies between the left atrium (upper heart chamber) and the left ventricle (lower heart chamber).

What is valve disease?

Valve disease occurs when your heart's valves do not work correctly. This can be caused by valve stenosis (stiff, fused, inflexible leaflets, limiting the flow of blood) or valve regurgitation (leaky heart valve, occurs when the leaflets do not close completely). Learn more about valve disease.

Mitral valve surgery

When the mitral valve does not function properly, the mitral valve must be repaired or replaced. At Cleveland Clinic, mitral valve repair is the procedure of choice for most patients with mitral valve disease. If you require mitral valve surgery, either repair or replacement, you may be a candidate for robotically assisted mitral valve surgery

Robotically-Assisted Valve Surgery: smaller incision

Traditional, open-chest surgeries, such as mitral and tricuspid valve surgery, and bypass surgery involve: placing the patient on the heart-lung bypass machine to circulate oxygenated blood during surgery; creating a 6- to 8-inch incision through the sternum; spreading the ribs to view the heart and stopping the heart in order to stabilize the blood vessels.

Conventional minimally invasive surgery decreases the size of the incision to about 3 to 4 inches. The minimally-invasive robotically-assisted technique uses even smaller incisions – often less than 2 inches. The surgeon's hands control the movement and placement of the endoscopic instruments to open the pericardium (a thin sac that surrounds the heart) and to perform the procedure. In most cases, the sternum or breastbone does not need to be opened, and the ribs do not need to be spread to perform the procedure.

How does robotically assisted heart surgery work?

During mitral valve surgery, the surgeon can get an undistorted 3-D view of the mitral valve, leaflets, and subvalvular structures with the use of a high powered camera — moreover, a lateral thoracic approach. The robotic surgical system is used to control instruments, which are attached to thin, robotic arms. The surgeon's hands control the movement and placement of the instruments. The robotic "arm and wrist" movements mimic those of the surgeon's hand to enable the surgeon to follow the same steps as a traditional mitral valve surgery - including a variety of repair techniques and mitral valve replacement.

What are the benefits of robotically-assisted surgery?

Compared with traditional surgery, the benefits of robotically-assisted surgery include:

  • Smaller incisions with minimal scarring
  • Less trauma to the patient, including less pain
  • Shorter hospital stay (usually 3 to 4 days)
  • Decreased use of pain medications
  • Less bleeding
  • Reduced risk of infection
  • Shorter recovery and quicker return to daily and professional activities:

The patient can resume normal activities and work as soon as he or she feels up to it; there are no specific activity restrictions after robotically-assisted surgery.