Donias Harry W, Karamanoukian Hratch L, D'Ancona Giuseppe, Hoover Eddie L
Department of Surgery, State University of New York at Buffalo, USA.
Angiology. 2003 Jan;54(1):93-101. doi: 10.1177/000331970305400112.
Currently, there is a growing interest in minimally invasive cardiac surgery, and despite early criticisms, it has become the preferred method of mitral valve repair and replacement in many institutions worldwide with excellent results. The interest in performing cardiac valve operations through minimal incisions was stimulated by Port Access technology and has evolved to include robotically assisted video-enhanced valve surgery. Robotic assistance has led to shorter operating times and represents an ideal tool to prepare for fully robotic-assisted cardiac procedures. This report will highlight minimally invasive mitral valve surgery with its evolution from Port Access techniques to fully robotic-assisted surgery. The nuances, strengths, and shortcomings, as well as the potential to enhance the valvular procedure, the promise to reduce hospital stay, earlier return to normal activity, less pain, better cosmesis, and the rethinking of surgical dogma that wide surgical exposure is essential for such complex intracardiac surgery are discussed.
目前，微创心脏手术越来越受到关注，尽管早期受到一些批评，但它已成为全球许多机构二尖瓣修复和置换的首选方法，效果极佳。通过微小切口进行心脏瓣膜手术的兴趣受到端口入路技术的激发，并已发展到包括机器人辅助视频增强瓣膜手术。机器人辅助已导致手术时间缩短，是为全机器人辅助心脏手术做准备的理想工具。本报告将重点介绍微创二尖瓣手术，及其从端口入路技术到全机器人辅助手术的演变。文中还讨论了其中的细微差别、优势和缺点，以及增强瓣膜手术的潜力、缩短住院时间、更早恢复正常活动、减轻疼痛、改善美观的前景，以及对手术教条的反思，即广泛的手术暴露对于这种复杂的心内手术至关重要。
