Falk Volkmar, Jacobs Stephan, Gummert Jan, Walther Thomas
Department of Cardiac Surgery, Heart Center, University of Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany.
Surg Clin North Am. 2003 Dec;83(6):1381-6, ix. doi: 10.1016/S0039-6109(03)00165-8.
Technical and anatomical limitations as well as human factors complicate endoscopic coronary bypass surgery. Computer-enhanced telemanipulation systems overcome some of these shortcomings by restoring the dexterity and precision of a distant operator (surgeon) within a confined space. Endoscopic coronary artery bypass grafting (CABG) has evolved from a merely experimental approach to a clinical concept. Although CABG was initially exclusively performed on the arrested heart, adjunct technologies such as endoscopic vacuum-assisted stabilizers now allow a closed-chest, beating-heart procedure. The development of anastomotic devices, and further refinements in telemanipulator technology, optical systems, and image-guided augmented-reality scenarios will greatly facilitate endoscopic bypass grafting in the future.
技术和解剖学上的限制以及人为因素使内镜冠状动脉搭桥手术变得复杂。计算机增强远程操作手术系统通过在有限空间内恢复远程操作者（外科医生）的灵活性和精确性克服了其中一些缺点。内镜冠状动脉旁路移植术（CABG）已从仅仅是一种实验性方法发展成为一种临床概念。尽管最初CABG仅在心脏停搏时进行，但诸如内镜真空辅助稳定器等辅助技术现在允许进行不开胸的心脏跳动手术。吻合装置的发展以及远程操作技术、光学系统和图像引导增强现实场景的进一步改进将在未来极大地促进内镜旁路移植术。
