Objective: The robot represents the next development in minimally invasive surgical technique.This is a description of our clinical experience with occlusive disease, aneurysums, and hybrid procedures using the da Vinci system.The da Vinci surgical robot is a multi-armed apparatus composed of three primary parts.The first is a patient-side cart which may use three or even four arms; the second is the instrument tower.The third element is the surgeons workplace, known as the operating console, which controls the arms and their miniature instruments.A 3D visualization provides the surgeon with a perfect view of the operative field within the patient.A high-performance computer is also an essential system component.Methods: 210 robot-assisted vascular operations were performed between November 2005 and June 2011.164 of these patients were prospectively evaluated for occlusive disease, 39 were evaluated for abdominal aortic aneurysm, two for a common iliac artery aneurysm, two for a splenic artery aneurysm, one for type Ⅱ endoleak treatment after endovascular repair and two for hybrid procedures.The robotic system was utilized to construct the vascular anastomosis; for the thromboendarterectomy; for the aorto-iliac reconstruction with the patch closure; for dissection of arteries; and for the posterior peritoneal suture.Our clinical experience in laparoscopic surgery has allowed us to modify and simplify some of these procedures and stages.These developmental changes have subsequently been incorporated into standard robotic vascular practices.A combination of conventional laparoscopic and robotic surgeries provide the study basis.A modified full robotic approach without laparoscopic surgery was used in the last 40 cases of our serie.Results: 203 cases (97%) were successfully completed robotically.One surgery was discontinued during laparoscopy due to heavy aortic calcification.In six patients (2,8%) conversion was necessary.The thirty-day mortality rate was 0,5% and non-lethal postoperative complications were observed in nine patients (4,3%).Conclusions: Clinical experience with robotic-assisted laparoscopic surgery has shown it is a feasible technique for use in vascular surgery.The da Vinci system facilitates the creation of the aortic anastomosis and shorter aortic clamping time as compared to purely laparoscopic techniques.The advantage of this new technology is that it significantly improves surgical procession by the elimination of operator hand tremor; and through its perfect 3D imaging.It is also possible to perform surgical interventions in areas that are difficult to access using standard surgical or laparoscopic techniques.The obvious result is these operations dramatically insure improved patient safety, comfort and recovery.