Introduction
Myxoma is the most common benign cardiac tumor. The incidence was reported to be 60–80% at the left atrium, 15-28% at the right atrium, 8% at the right ventricle, and 3-4% at the left ventricle. The atrioventricular valve area was the least common origin (1%) [1,2]. There are several approaches to remove myxoma, including traditional sternotomy, minimally invasive thoracotomy, and robot-assisted surgery. Robot-assisted endoscopic operation was done for huge tumor excision and tricuspid valve (TV) repair. During the operation, the myxoma was downsized with a morcellator (NOUVAG AG, Inc, Goldach, Switzerland) in the pericardial cavity. Simultaneous TV repair was completed from the endoscopic working ports.