Standalone totally thoracoscopic left appendage clipping: Safe, Simple, Standardized.

Abstract Totally thoracoscopic standalone left atrial appendage exclusion (LAAE) has become a valid treatment option for stroke prevention in patients with a contraindication to anticoagulants. As most other video assisted surgeries, this procedure requires the appropriate patient, proper port positioning to obtain the most advantageous working angles, and standard thoracoscopic skills. Furthermore, it is mandatory to have a closure device specifically designed for the appendage; this to guarantee efficacy, safety and to optimize surgical placement allowing best clinical outcomes. Here, we describe the surgical technique of unilateral left-sided thoracoscopic approach for surgical exclusion of the appendage on the beating heart.