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Safe launch of a robotically assisted mitral valve repair program in a single center: experience of initial 20 cases under the Center for Minimally Invasive Surgery

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Abstract

Robotically assisted mitral valve repair was approved by the Japanese government in April 2018. However, understanding robotic surgery involves steep learning curves of surgeons and dedicated cardiac teams. The Center for Minimally Invasive Surgery (CMIS) of Tottori University Hospital is a multidisciplinary organization established in 2011 with seven surgical departments. In this study, we report strategies for improving the safety of robotic surgery in the CMIS and early results of robotic mitral valve repair at our hospital. We reviewed the first 20 patients who underwent robotic primary mitral valve repair, including concomitant procedures, from October 2019 to September 2021 under the supervision of the CMIS. Before starting the program, the CMIS requires setting console time limit to 180 min and implementing risk management strategies through simulation training for various mechanical failures. Mitral valve repair was completed in all patients. There was no in-hospital or 30-day mortality. No conversion to median sternotomy was necessary. The analysis of mitral pathology revealed 1 case of functional mitral regurgitation, 12 cases of posterior lesions, 3 cases of anterior lesions, 3 cases of bileaflet lesions, and 1 case of commissural lesion. The average cross-clamp time was 133 ± 27 min. Sixteen cases had trace mitral regurgitation postoperatively, and 4 cases had mild mitral regurgitation. The median (interquartile range) postoperative hospital stay was 10 (8.5–12.5) days. Robotically assisted mitral valve repair was performed safely with assistance from the multidisciplinary CMIS, and the early results were satisfactory without compromising clinical outcomes.

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan

    Yasushi Yoshikawa, Yuichiro Kishimoto, Takeshi Onohara, Hiromu Horie, Kunitaka Kumagai, Rikuto Nii, Nozomi Kishimoto, Kenichi Morimoto, Yuki Yoshikawa & Motonobu Nishimura

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  1. Yasushi Yoshikawa
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  2. Yuichiro Kishimoto
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  3. Takeshi Onohara
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  4. Hiromu Horie
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  5. Kunitaka Kumagai
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  6. Rikuto Nii
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  7. Nozomi Kishimoto
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  8. Kenichi Morimoto
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  9. Yuki Yoshikawa
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  10. Motonobu Nishimura
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Correspondence to Yasushi Yoshikawa or Motonobu Nishimura.

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The authors declare that they have no conflict of interest.

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All patients provided written informed consent for surgery and the use of their data and samples for diagnostic and research purposes. The data collection, analysis, and reporting procedures were approved by the Institutional Review Board of Tottori University Faculty of Medicine (approval number: 21A-232).

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Yoshikawa, Y., Kishimoto, Y., Onohara, T. et al. Safe launch of a robotically assisted mitral valve repair program in a single center: experience of initial 20 cases under the Center for Minimally Invasive Surgery. J Artif Organs 26, 226–232 (2023). https://doi.org/10.1007/s10047-022-01348-x

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  • DOI: https://doi.org/10.1007/s10047-022-01348-x

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