Dear Colleagues,

Since robotic technology was introduced into the cardiac surgical field in the late ‘90s, the dream of cardiac surgeons to perform cardiac procedures in the closed chest has come true. During the last two decades, several pioneering teams from all over the world have demonstrated that is possible to perform almost the whole spectrum of adult cardiac surgery in a safe and reproducible way.

Despite the amazing outcomes achieved, robotic-assisted cardiac surgery has never taken off on a large global scale due to multiple issues: the initial steep learning curve, highly demanding and time-consuming procedures, lack of investments from industries, the parallel advancement of the transcatheter field, and last, but not least, the high cost of the robotic platform.

However, in recent years, minimally invasive cardiac surgery (MICS) has been adopted successfully world-wide, and robotic-assisted cardiac surgery is gaining a renewed interest.

In addition, an increasing number of robotic platforms and instruments have recently been launched on the market making this complex discipline more appealing.

Now more than ever, the field of cardiac surgery is facing tremendous challenges. On one side the transition from standard open to large adoption of MICS and the need to achieve non-inferior outcomes, and on the other one the literal potential extinction of this discipline in favor of the transcatheter procedures.

In this rapidly changing landscape, robotic-assisted cardiac surgery can play a pivotal role in leading the discipline to the next level.

The new generations of cardiac surgeons have been called once again to raise the bar and pave the way to a future of closed chest cardiac surgery aiming to unleash terrific outcomes for our patients.

This special issue has the goal of collecting the new ideas, opinions, strategies, and evidence-based results of these leading teams that have established a successful robotic program. The articles in this issue will have the potential to spread knowledge on this topic to help other programs to embark on this complex and fascinating journey.

Prof. Massimo Bonacchi and Dr. Francesco Cabrucci
Guest Editors