Abstract: Objective To summarize the experience with the application of robotic technique in totally endoscopic atrial septal
defect closure in a single center. Methods Between January 2007 and September 2011, 115 patients with the diagnosis of
secundum type atrial septal defects underwent robotic atrial septal defect repair with the assistance of da Vinci surgical
system. The patients had a median age of 35 years and a median defect diameter of 28 mm. Cardiopulmonary bypass was
established via peripheral cannulation. Via three 8-mm ports and one 15-mm port in the right chest, the surgeon manipulated
the microinstruments to complete the defect closure with or without tricuspid valve plasty. Echocardiography was performed
intraoperatively, before discharge and at 30 days after the operation. Results Atrial septal defect closure was completed on
arrested heart in 44 patients and on beating heart in 61 patients. No deaths or conversions to alternate techniques occurred in
these cases. No residual shunt was detected by intraoperative or postoperative echocardiography. The mean operating time
and cardiopulmonary bypass time on bearing heart group were significantly shorter than those on arrested heart group. The
median ventilation time, intensive care unit stay, drainage volume, or length of hospital stay showed no significant differences
between the two groups. Conclusion Secundum type atrial septal defect closure can be successfully performed with the
assistance of the robotic system with good surgical results.