title: Totally endoscopic robotic ventricular septal defect repair.
abstract: OBJECTIVE
  Recent advances in robotic instrumentation have facilitated totally endoscopic intracardiac procedures. However, totally endoscopic robotic ventricular septal defect (VSD) repair has not been reported in the literatures to our knowledge. We report our first three cases of closed chest VSD repair using da Vinci S Surgical System.
  
  
  METHODS
  Three female patients underwent totally endoscopic robotic VSD repair. Echocardiography demonstrated that the perimembranous VSD sizes in three patients were 6, 8, and 8 mm, respectively, and a patent foramen ovale in one patient.
  
  
  RESULTS
  All the VSD repair and right atrial closure were completed with the da Vinci robot. Mean cardiopulmonary bypass and mean cross-clamp times were 70 and 22 minutes, respectively. No blood transfusions were received. Postoperative transesophagel echocardiogram (TEE) demonstrated intact ventricular septum. The mean hospital stay was 5 days. The patients returned to normal function without any complications.
  
  
  CONCLUSIONS
  With a limited number of cases, the study showed that totally endoscopic robotic VSD repair in adult patients is feasible and safe.
authors.affiliation: Department of Cardiovascular Surgery, PLA General Hospital, Beijing, China. gaochq301@yahoo.com
authors.forename: Changqing
authors.initials: C
authors.lastname: Gao
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Jiali
authors.initials: J
authors.lastname: Wang
authors.forename: Cangsong
authors.initials: C
authors.lastname: Xiao
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao