Takanashi Yoko, Hamano Hiroko, Miyata Kazuto, Matsumoto Shouhei, Isshiki Atushi
Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023.
Masui. 2010 Feb;59(2):193-6.
Robot-assisted minimally invasive surgery has become common in recent years. We used the da Vinci surgical system and managed anesthesia in 6 cases of bilateral internal mammary artery dissection and construction of a composite graft using the radial artery. To ensure vision inside the thoracic cavity, endoscopic robotic surgery employs the inflation of the thoracic cavity with carbon dioxide, producing a pneumothorax and turning the thoracic cavity into a positive pressure chamber. Thus, marked acidosis and circulatory changes manifest during anesthetic management. Although robotic surgery is considered "minimally invasive, such surgery involves a number of problems in terms of anesthetic management, and these problems must be examined.
近年来，机器人辅助微创手术已变得很常见。我们使用达芬奇手术系统，对6例双侧胸廓内动脉游离及采用桡动脉构建复合移植物的患者进行麻醉管理。为确保胸腔内视野，内镜机器人手术通过向胸腔内注入二氧化碳使胸腔膨胀，从而产生气胸并将胸腔转变为正压腔。因此，在麻醉管理过程中会出现明显的酸中毒和循环变化。尽管机器人手术被认为是“微创手术”，但这种手术在麻醉管理方面存在诸多问题，必须对这些问题进行研究。
