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一种使用双对接技术进行冠状动脉旁路移植术的新型机器人双侧乳内动脉采集方法。

A Novel Robotic Bilateral Internal Mammary Artery Harvest Using Double Docking Technique for Coronary Artery Bypass Grafting.

作者信息

Tarui Tatsuya, Ishikawa Norihiko, Watanabe Go

机构信息

From the Department of Cardiovascular Surgery, NewHeart Watanabe Institute, Tokyo, Japan.

出版信息

Innovations (Phila). 2017 Jan/Feb;12(1):74-76. doi: 10.1097/IMI.0000000000000331.

Abstract

da Vinci Surgical System (da Vinci) enabled port access for internal mammary arteries (IMA) harvesting. However, bilateral IMA (BIMA) harvesting is difficult when performed on single side. We developed a novel technique of double docking the da Vinci by transpositioning from the left side to the right and examined the feasibility. Twelve patients underwent BIMA harvesting using the double-docking technique. First, the da Vinci was set on the patient's left side for the right IMA harvesting. Afterward, the da Vinci was undocked and transpositioned from the patient's left side to the right side. The time elapsed during rotation was measured. Subsequently, the left IMA was harvested from patient's right side. Distal anastomoses were performed by a small anterolateral thoracotomy. All of the IMAs were harvested and then bypassed without damage. The mean ± SD time that elapsed during rotation was 6.5 ± 0.6 minutes. There was no conversion to sternotomy. Bilateral IMA harvesting by the bilateral docking technique was performed successfully with acceptable feasibility.

摘要

达芬奇手术系统(da Vinci)实现了用于获取胸廓内动脉(IMA)的端口接入。然而,在单侧进行双侧IMA(BIMA)获取时存在困难。我们开发了一种通过从左侧移位到右侧来对da Vinci进行双重对接的新技术,并检验了其可行性。12例患者采用双重对接技术进行了BIMA获取。首先,将da Vinci置于患者左侧以获取右侧IMA。之后,将da Vinci从患者左侧解对接并移位到右侧。测量旋转过程中所花费的时间。随后,从患者右侧获取左侧IMA。通过小切口前外侧开胸进行远端吻合。所有IMA均成功获取且未受损伤。旋转过程中所花费的平均±标准差时间为6.5±0.6分钟。没有转为胸骨切开术。采用双侧对接技术成功进行了双侧IMA获取,可行性可接受。

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