Robotic-assisted totally endoscopic cardiac surgery has been performed for more than a decade in Europe and in the United States of America. Since the first procedures, much has been discussed about its feasibility, safety and, moreover, its results. A growing involvement of large centers with this new modality has been observed throughout these years of development. One of the major reasons of motivation is the reduced surgical trauma, because a smaller amount of tissue is sectioned and/or manipulated. Other characteristics of the technique are the shorter length of hospital stay associated with the perception of greater patient satisfaction and earlier return to their social and professional activities in comparison to the conventional open procedures.
　　The robotic cardiac surgery is just launched and permitted by Japan Cardiac Society. The mitral valve procedures are insurance coverage and the society regulate the basic training requirement and monitoring the result. There is no strict regulation and result monitoring in Taiwan.