Totally Endoscopic Ventricular Septal Defect Closed: How to do it?

Abstract

Objectives: To describe the procedure of totally endoscopic closure of ventricular septal defect (VSD) without robotic assistance. Methods: Totally endoscopic VSD closure was performed in 17 patiens (12 childrens and 5adults). The age was 8,5 year olds ( from 3 to 46), and the body weight was 31,2 kg (from 10 to 57). 16 patients were diagnosed with peri-membranous VSD and 1 infundibular VSD, in which 5 patients had right ventricular outflow tract stenosis. We used three 5mm-trocarts  and one 12mm-trocart in the right chest. Using pperipheral cannulation for ccardiopulmonary bypass, superior vena caval occlusion, Chitwood aortic clamp, right atriotomy and closing VSD by totally endoscopy without a robotically assisted surgical system. Results: There were no postoperative complications and deaths. cardiopulmonary bypass time and Aortic clamping time were 120 mins and 70 mins respectively. The mean mechanical ventilation time was 1.5 hours. Patients was hospitalized for 5.4 days and could resume normal daily activitive after 1 week. Conclusions: Totally endoscopic closure of ventricular septal defect without robotic assistance is safe and feasible leaving only a small surgical scar with good aesthetics.