Minimally invasive pediatric cardiac surgery, although still evolving, lacks much of the corporate "thunder" directed to wards the adult patient. Because the majority of pediatric procedures remain "open" requiring cardiopulmonary bypass, innovations and/or modifications of already established tech niques might have important adult medical applications. The care of children born with congenital heart disease at our institution presently incorporates cardioscopy, active venous suction, epidural/spinal anesthesia, and, most recently, robotic video assistance. This mufti-disciplinary combination has not only optimized the cosmetics of the operation and use of hospital resources but also has maintained the safety and reproducibility of the surgical interventions.