Diodato Michael D, Damiano Ralph J
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes Jewish Hospital, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
Surg Clin North Am. 2003 Dec;83(6):1351-67, ix. doi: 10.1016/S0039-6109(03)00166-X.
Most endoscopic procedures are excisional, not reconstructive or microsurgical, mostly because conventional endoscopic instrumentation lacks dexterity due to long, nonarticulated instruments, a fixed pivot point and counterintuitive movement of the instrument tip, and lack of depth perception. Endoscopic approaches to cardiac surgery have not been successful; however, the development of robotic surgical systems has overcome many limitations of endoscopy. Computer-assisted surgery has created a computerized digital interface between the surgeon's hands and surgical instrument tips and enhances surgical ability, thereby enabling endoscopic microsurgery. Recently, robotic systems have allowed cardiac surgeons to perform minimally invasive endoscopic coronary artery bypass grafting (CABG) and valve procedures. This article summarizes the use of robotics in cardiac surgery and discusses its potential in our specialty.
大多数内镜手术都是切除性的，而非重建性或显微外科手术，主要原因是传统的内镜器械由于器械长、无关节、枢轴点固定、器械尖端运动与直觉相反以及缺乏深度感知而缺乏灵活性。心脏手术的内镜方法尚未成功；然而，机器人手术系统的发展克服了内镜检查的许多局限性。计算机辅助手术在外科医生的手和手术器械尖端之间创建了一个计算机化数字接口，并提高了手术能力，从而实现了内镜显微手术。最近，机器人系统使心脏外科医生能够进行微创内镜冠状动脉旁路移植术（CABG）和瓣膜手术。本文总结了机器人技术在心脏手术中的应用，并讨论了其在我们这个专业领域的潜力。
