Toolan Caroline, Palmer Kenneth, Al-Rawi Omar, Ridgway Tim, Modi Paul
The Liverpool Heart & Chest Hospital, Liverpool, UK.
J Thorac Dis. 2021 Mar;13(3):1971-1981. doi: 10.21037/jtd-20-1790.
Totally endoscopic robotic mitral valve repair represents the least invasive surgical therapy for mitral valve disease. Comparative results for robotic mitral valve surgery against sternotomy are impressive, repeatedly demonstrating shorter hospital stay, faster return to normal activities, less morbidity and equivalent mortality and mid-term durability. We lack data comparing robotic approaches to totally endoscopic minimally invasive mitral valve surgery using 3D vision platforms. In this review, we explore the advantages and disadvantages of robotic mitral valve surgery and share technical tips that we have learned to help teams embarking on their robotic journey. We consider factors necessary for the successful implementation of a robotic programme including the importance of training a dedicated team, with the common goal to avoid any compromise in either patient safety or repair quality during the learning curve. As experience grows with robotic techniques and more cardiac surgeons become proficient with this innovative technology, the volume of robotic cardiac procedures around the world will increase helped by the introduction of new robotic systems and patient demand. Well informed patients will increasingly seek out the opportunity of robotic valve reconstruction in reference centres in the hands of a few highly experienced robotic surgeons.
全内镜机器人二尖瓣修复术是二尖瓣疾病创伤最小的外科治疗方法。机器人二尖瓣手术与胸骨切开术相比的结果令人印象深刻，多次表明住院时间更短、恢复正常活动更快、发病率更低以及死亡率和中期耐久性相当。我们缺乏将机器人手术方法与使用3D视觉平台的全内镜微创二尖瓣手术进行比较的数据。在这篇综述中，我们探讨了机器人二尖瓣手术的优缺点，并分享我们学到的技术技巧，以帮助团队开启他们的机器人手术之旅。我们考虑了成功实施机器人手术计划所需的因素，包括培训一支专业团队的重要性，共同目标是在学习曲线期间避免患者安全或修复质量受到任何影响。随着机器人技术经验的积累以及越来越多的心脏外科医生精通这项创新技术，在新机器人系统的引入和患者需求的推动下，全球机器人心脏手术的数量将会增加。消息灵通的患者将越来越多地寻求在少数经验丰富的机器人外科医生所在的参考中心接受机器人瓣膜重建的机会。
