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黏液瘤全机器人切除术及房间隔缺损修补术

Totally robotic resection of myxoma and atrial septal defect repair.

作者信息

Gao Changqing, Yang Ming, Wang Gang, Wang Jiali

机构信息

Department of Cardiovascular Surgery, PLA General Hospital, 28 Fuxing Rd, Beijing 100853, China.

出版信息

Interact Cardiovasc Thorac Surg. 2008 Dec;7(6):947-50. doi: 10.1510/icvts.2008.185991. Epub 2008 Sep 16.

Abstract

Resection of left atrial myxoma and large atrial septal defect repair were performed in 55 patients using the da Vinci S surgical system to evaluate device safety and efficacy. Fifty-five patients underwent resection of left atrial myxomas (n=10) or secundum-type ASD (n=45) repairs with three cases of concomitant tricuspid valve repairs, using the da Vinci S surgical system. Mean age of the patients was 38+/-12.2 years (range 12-61 years). Cardiopulmonary bypass was achieved peripherally, aortic occlusion was performed with Chitwood cross-clamp, and antegrade cardioplegia was administered via anterior chest. Via four port incisions in the right chest and a 2-2.5-cm working port, all the procedures were completed with the da Vinci robot. All patients had successful resection or repairs. The mean CPB times and aortic cross-clamp times were 108.6+/-12.5 min and 45+/-11.5 min, respectively. There were no operative deaths, strokes, or device-related complications. One patient was reexplored for bleeding. There were no incisional conversions. All the patients were discharged. da Vinci S surgical system has no limitations to safe resection of left atrial myxomas and of ASD repairs, surgical results are excellent, and this technology is of reproducible value with excellent cosmetic results.

摘要

使用达芬奇S手术系统对55例患者进行了左心房黏液瘤切除术和大型房间隔缺损修补术,以评估该设备的安全性和有效性。55例患者使用达芬奇S手术系统进行了左心房黏液瘤切除术(n = 10)或继发孔型房间隔缺损修补术(n = 45),其中3例同时进行了三尖瓣修补术。患者的平均年龄为38±12.2岁(范围12 - 61岁)。通过外周建立体外循环,使用奇伍德交叉夹闭器进行主动脉阻断,并通过前胸给予顺行性心脏停搏液。通过右胸的四个端口切口和一个2 - 2.5厘米的工作端口,所有手术均由达芬奇机器人完成。所有患者均成功完成切除或修补。平均体外循环时间和主动脉阻断时间分别为108.6±12.5分钟和45±11.5分钟。无手术死亡、中风或与设备相关的并发症。1例患者因出血接受再次探查。无切口转换情况。所有患者均出院。达芬奇S手术系统在安全切除左心房黏液瘤和修补房间隔缺损方面没有局限性,手术效果极佳,这项技术具有可重复性价值且美容效果良好。

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