Minimally invasive lumpectomy has developed considerably in the last two decades and has become a standard procedure in specific surgical fields. In the field of cardiovascular surgery, especially coronary artery bypass grafting, the application of lumpectomy faces numerous technical challenges: there is no technical basis for the application of lumpectomy in cardiac surgery; lumpectomy further increases the difficulty of otherwise complex cardiac surgery; and attempts to perform coronary artery bypass grafting using conventional thoracoscopy have been unsuccessful. With the development of computer and automatic control technology, robotic surgical systems became a reality. Robotic surgery systems were originally designed to allow remote remote surgery in extreme environments, allowing the operator to operate away from the operating table and remotely control minimally invasive instruments on a robotic arm, working in accordance with the model of total lumpectomy with the chest cavity closed. In 1998, Loulmet performed the world’s first robotic-assisted coronary artery bypass graft using the da Vinci robotic system, and since then the technology has made steady and significant progress. Currently, the robotic surgical system has evolved to a third-generation product with high-definition simulation and a dual console; the surgical technique has evolved from simple anterior descending bypass to multi-vessel anastomosis. In this paper, we present the current clinical application of robotic-assisted coronary artery bypass grafting. The first step to achieve totally robotic/endoscopic coronary artery bypass graft (TECAB) is to free the internal mammary artery. Three small 0.8 cm diameter holes are punched in the left chest wall and minimally invasive robotic instruments are inserted, and the internal mammary artery is dissected in a three-dimensional view with a tipped or skeletal approach in front of a robotic console. The skeletal approach provides a longer internal mammary artery than the tipped approach and facilitates anastomosis to the coronary artery. Left-sided, right-sided or bilateral internal mammary artery dissection can be accomplished by left-sided chest wall perforation. The time for robotic internal mammary artery dissection ranges from 19 to 180 minutes, and most operators can complete unilateral internal mammary artery dissection within 30 minutes after an initial learning curve of 15 to 20 cases. Compared with internal mammary artery dissection under a small incision, the entire internal mammary artery can be easily dissected under the robot, and the length is not limited by the incision. In China, robotic internal mammary artery dissection was carried out in January 2007, and unilateral and bilateral internal mammary artery dissection were reported, and there is no report of abandonment due to damage of internal mammary artery caused by robotic system.