What is the difficulty and “originality” of the procedure? There are three main aspects of significance. 1, “completely open-heart” robotic operation. At present, many medical institutions at home and abroad have carried out da Vinci robotic heart surgery, and since 2009, Zhongshan Hospital has successfully applied the da Vinci robot to complete heart surgery for 76 patients, which is the leading level in China. Most hospitals perform robotic bypass surgery by manipulating the robot to obtain the left internal mammary artery, and then the surgeon completes the anastomosis between the bridge vessel and the anterior descending branch through a small 5-8 cm incision in the left chest wall under direct vision. This has significantly reduced the surgical trauma compared to traditional bypass surgery with a median sternotomy, but still requires an open chest. In this case, our team successfully achieved a fully robotic operation with “no chest opening” through only a few poked microscopic holes in the chest wall, which minimized the trauma of the bypass surgery. 2. Suture anastomosis. The fully robotic coronary anastomosis carried out abroad mostly adopts a kind of metal wire “U-CLIP” which can be automatically fastened. Although this method is relatively easy to operate, the metal wire remains permanently in the vessel lumen after surgery, which may affect the long-term patency of the vessel and the risk of thrombosis. We used ultra-fine polypropylene suture anastomosis this time, which has almost no adverse irritation to the vascular tissue and can significantly reduce such risks, but requires more skill for the surgeon. 3. The heart does not stop beating. It is conceivably difficult to perform a 1-2mm diameter vessel anastomosis on a beating heart, but it can avoid myocardial reperfusion injury for the patient and help protect cardiac function, and the patient has less bleeding, less risk, and faster recovery. With the help of the da Vinci robot’s 10x magnification and special heart stabilizers, the surgeon accomplished a more precise vascular anastomosis in the beating heart than in traditional open-heart surgery. Postoperative review of the coronary CT in this patient showed a very patent vascular bridge from the left internal mammary artery to the anterior descending branch. Is da Vinci robotic surgery one of the minimally invasive procedures? What is the situation of using minimally invasive surgery in the field of cardiac surgery? In the case of cardiac surgery, the traditional procedure involves a median sawing of the sternum with an incision 20 to 30 cm long, which is very traumatic, with a lot of bleeding and slow recovery. Patients are exposed to many postoperative risks, such as limited inspiratory function, limited upper limb movement, reduced thoracic stability, poor sternal healing and even mediastinal infection. Moreover, the incision is made in the middle of the chest, which affects the aesthetics and can have a negative impact on the patient’s future life and psychology. What are the benefits of minimally invasive heart surgery for patients? What kind of people is it suitable for? The benefits of minimally invasive heart surgery are obvious to patients. While achieving the same results as traditional open-heart surgery, the incision in the chest wall is moved from the median to the rib cage of the chest wall, the length is shortened from 20 to 30 cm to 4 to 8 cm, or even through a few poke holes, and the post-operative hospital stay is shortened from about ten days to four or five days. Since the procedure does not require sawing through the sternum, it does not destabilize the patient’s thorax, much less affect the patient’s future upper extremity movement and physical activity, and avoids the risk of poor sternal healing. Currently, cardiac surgery such as coronary artery bypass grafting (severe stenosis of the anterior descending or diagonal branches), simple mitral valve replacement or repair, tricuspid valve replacement or repair, aortic valve replacement, atrial defect repair, and cardiac mucosal aneurysm removal can be performed through minimally invasive or “da Vinci” robotic techniques. It is important to note that minimally invasive cardiac surgery may not be appropriate for patients with a history of previous chest surgery or chest infection, severe obesity, or severe whistling insufficiency.