Totally Endoscopic Non-robotic Mitral Valve Repair Through 12mm Working Port: How We Do It
Dat Thanh Pham1, Huu Cong Nguyen1, Thanh Ngoc Le2.
1E Hospital, Hanoi, Viet Nam, 2University of Medicine and Pharmacy - Vietnam National University, Hanoi, Viet Nam.
BACKGROUND: We have made use of totally endoscopic surgery through working ports under 12mm without robotic assistance in mitral valve repair.
METHODS: Peripheral extracorporeal circulation was established. Endoscopic topography: A 12mm working port in the 5th intercostal space (ICS) between the right midclavicular and anterior axillary line, a port in the 3rd ICS in the anterior axillary line for tissue forceps, one port in the 5th ICS in the midaxillary line for the 3D camera, an incision in the 2nd intercostal space in either the midaxillary or anterior axillary line for aortic clamping. Antegrade cardioplegia was used. For left atrial exposure, we used the retraction sutures to access the mitral valve. The repair techniques were conventional.
RESULTS: Five patients were performed successfully. No conversion to full sternotomy. The mean aortic cross-clamp time and cardiopulmonary bypass time were 105 minutes and 165 minutes respectively. The average ventilation time was 15.2 hours. For the intensive care unit time, the average was 2.1 days. No death and no recurrent regurgitation were recorded.
CONCLUSIONS: This technique is safe, effective and cost-efficient. It can be performed without the robotic system, which is adopted easily in the developing countries. 
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