Port-access atrium retractors for totally endoscopic mitral valve surgery: The Tornado Retractor, the Butterfly Retractor, and the Semiautomatic Butterfly Retractor

We developed three types of new atrial retractors that facilitate totally endoscopic mitral valve surgery.

Tornado Retractor: This retractor, which is made of rigid thick wire has a unique appearance, and can be inserted atraumatically through a 3-mm skin incision. Butterfly Retractor: This retractor consists of two parts: a rigid thick rod and foldable blades. When unfolded, the blades have a width of 35 × 55 mm, but they can be inserted thorough the 15-mm thoracoport when folded. Semiautomatic Butterfly Retractor: This retractor has a wired foldable blade and a specially designed rod containing a spring. It can be inserted when closed through the 15-mm thoracoport, and the blades can be opened and fixed automatically after being placed in the thoracic cavity, and the surgeon can remove it through the port easily. These retractors were evaluated in the totally endoscopic robotic mitral valve repairs with human fresh frozen cadavers using the da Vinci^TM Surgical System.

All the retractors allowed easier access to the heart and provided superior mitral valve presentation without impinging on the robotic arms.