Morgan Jeffrey A, Ginsburg Mark E, Sonett Joshua R, Morales David L S, Kohmoto Takushi, Gorenstein Lyall A, Smith Craig R, Argenziano Michael
Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Eur J Cardiothorac Surg. 2003 Jun;23(6):883-7; discussion 887. doi: 10.1016/s1010-7940(03)00160-x.
Computer (robotic) enhancement has been used to facilitate simple thoracoscopic procedures such as internal mammary artery (IMA) mobilization. This report describes the use of robotic technology in advanced thoracoscopic procedures.
Ten patients underwent advanced thoracoscopic procedures utilizing the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA) at our institution.
Patients 1-6 underwent endoscopic phrenic nerve mobilization with insertion of phrenic nerve pacemakers. The indications were quadriplegia (n=2), central hypoventilation syndrome (n=2), and intractable hiccups (n=2). Three 1-cm incisions were made to access each hemithorax. Patients 7 and 8 underwent robotically assisted resection of posterior mediastinal masses. Patient 9 underwent robotically assisted thoracoscopic left lower lobectomy for a lung mass. Patient 10 underwent robotically assisted left ventricular lead placement for biventricular pacing for heart failure.
Robotic technology can be used to perform advanced intrathoracic maneuvers thoracoscopically. The increased visualization and instrument dexterity afforded by this technology may facilitate the development of minimally invasive thoracic approaches that were previously not feasible.
计算机（机器人）辅助技术已被用于辅助诸如胸廓内动脉（IMA）游离等简单的胸腔镜手术。本报告描述了机器人技术在复杂胸腔镜手术中的应用。
在我们机构，10例患者接受了使用达芬奇机器人手术系统（直观外科公司，加利福尼亚州山景城）的复杂胸腔镜手术。
患者1 - 6接受了内镜下膈神经游离并植入膈神经起搏器。适应证包括四肢瘫痪（2例）、中枢性低通气综合征（2例）和顽固性呃逆（2例）。通过3个1厘米的切口进入每个半胸。患者7和8接受了机器人辅助的后纵隔肿物切除术。患者9接受了机器人辅助的胸腔镜左下肺叶切除术以切除肺部肿物。患者10接受了机器人辅助的左心室导线植入术用于心力衰竭的双心室起搏。
机器人技术可用于胸腔镜下进行复杂的胸腔内操作。该技术提供的增强的可视化和器械灵活性可能有助于开发以前不可行的微创胸科手术方法。
