Micro-Invasive 3D Endoscopic Mitral Valve Surgery

Surg Technol Int. 2022 May 19:40:227-234. doi: 10.52198/22.STI.40.CV1530.

Abstract

Since its introduction in 1995, minimally invasive mitral valve surgery (MIMVS) has been shown to be a valid alternative to conventional sternotomy and several studies have reported excellent clinical outcomes. While MIMVS is now a commonly performed procedure, it is still difficult to standardize. We proprose here a "road to safer surgery", and offer some tips and tricks that could be useful in its learning and performance, and may help surgeons minimize the risk of major complications. With the introduction of 3D vision with a 3D videothoracoscope for 4K stereoscopic acquisition, a medical LCD ultra-HD monitor and active 3D glasses, it is possible to obtain a very realistic view of the surgical field and the mitral valve anatomy, while significantly reducing the learning curve. We describe the procedure step-by-step, with details from the pre-operative phase to the end of the operation. The procedure is structured in consecutive stages: patient induction and positioning, thoracoscopic access and port placement, surgical field exposure, and operative technique.

MeSH terms

  • Cardiac Surgical Procedures*
  • Endoscopy
  • Humans
  • Minimally Invasive Surgical Procedures / methods
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / surgery
  • Sternotomy / methods
  • Treatment Outcome