Robotic-assisted cardiac surgery has been performed internationally for many years and can be a safe and effective option when performed in appropriately selected patients by experienced cardiac surgical teams.

Patient selection is extremely important. Before recommending robotic surgery, the cardiac team evaluates the patient's heart condition, coronary and vascular anatomy, chest anatomy, lung function, previous surgeries and overall medical fitness. Depending on the condition, investigations may include echocardiography, CT imaging, coronary angiography and other cardiovascular assessments.

Eligibility depends on the type and complexity of the cardiac condition, the patient's anatomy, previous heart or chest surgeries, vascular access, lung function and overall health.

A detailed evaluation by the cardiac surgery team is required before deciding whether a robotic-assisted procedure is suitable. If robotic surgery is not appropriate, the team may recommend another minimally invasive technique or conventional open-heart surgery based on clinical requirements.

Both techniques use smaller incisions compared with conventional sternotomy-based surgery, but the instruments and visualisation systems differ.

Keyhole or thoracoscopic cardiac surgery generally uses specialised long instruments introduced through small chest incisions while the surgeon operates directly with those instruments.

Robotic cardiac surgery using the da Vinci Xi system provides a magnified high-definition 3D view together with wristed robotic instruments that can articulate within the chest. The system also provides motion scaling and tremor filtration, which can support precise dissection and suturing during technically demanding procedures.

Robotic-assisted cardiac surgery is performed through small incisions between the ribs rather than the conventional long midline chest incision used for sternotomy in suitable procedures. The size and location of incisions depend on the specific operation and surgical approach.

Recovery depends on the type of cardiac procedure, the patient's age, heart function and overall medical condition. Because selected robotic procedures avoid sternotomy, patients may be able to resume routine activities sooner than after conventional open-heart surgery. The treating cardiac surgeon and rehabilitation team provide personalised recommendations regarding walking, exercise, return to work, driving and other activities after surgery.