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Setting up a minimally invasive approach to mitral valve repair requires a mentored approach and team work of all personnel involved. Prior to program commencement the surgical team had site visits to an international centre of excellence.Over the last year, we have subsequently undertaken mitral repair using a thoracoscopic approach in 22 patients. Their ages ranged from 27 to 86 years, (11 male, 11 female) with a mean age 60 years. A specialist surgeon, experienced in minimally invasive mitral surgery was present at all cases.All patients had a successful mitral repair performed. One patient required conversion to full sternotomy. One patient had an abdominal bleed requiring interventional radiology coiling of the source artery. There were no re-operations and no patient required dialysis. On echo all patients had no, trivial or mild mitral regurgitation. There was 0% mortality and no peri-operative case of CVA or other major mobidity.Minimally invasive mitral valve repair is a feasible and beneficial option in mitral surgery. It has a learning curve and team training and proctoring are essential when developing it in a surgical unit. It has the potential to enhance patient care in a select group of patients.