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[机器人辅助二尖瓣修复成功的技巧]

[Tips for Successful Robot-assisted Mitral Valve Repair].

作者信息

Takahashi Yosuke, Shibata Toshihiko

机构信息

Department of Cardiovascular Surgery, Osaka Metropolitan University, Osaka, Japan.

出版信息

Kyobu Geka. 2022 Jul;75(7):498-503.

Abstract

Robot-assisted valve repair refers to an intervention added to conventional minimally invasive cardiac surgery( MICS), which is covered by national insurance since April 2018. However, currently, this procedure is performed only at a few hospitals, which is attributable to the need for specialized facilities, as well as surgeon-related criteria including high technical expertise. Notably, the learning curve to stabilize robotic surgery is longer than that for conventional MICS. Our hospital introduced robot-assisted valve repair in June 2018, and we have performed >120 surgeries to date. Our policy focuses on "no compromise in the quality of valve repair". The loop technique is routinely used for valve repair, and the experience gained from median sternotomy and MICS is directly applied to robotic procedures. Robot-assisted surgery enhances surgical field visualization and improves operability even in cases of complex valve repair. In this article, I will describe the procedural innovations, secure establishment of cardiopulmonary bypass, surgical outcomes, and the current challenges in robot-assisted valve repair to achieve safe and improved results.

摘要

机器人辅助瓣膜修复术是指在传统微创心脏手术(MICS)基础上增加的一种干预措施,自2018年4月起已纳入国家医保。然而,目前该手术仅在少数几家医院开展,这归因于需要专门的设备,以及包括高技术专长在内的与外科医生相关的标准。值得注意的是,稳定机器人手术的学习曲线比传统MICS更长。我院于2018年6月引入机器人辅助瓣膜修复术,迄今为止已完成120余例手术。我们的政策重点是“瓣膜修复质量不打折扣”。环扎技术常规用于瓣膜修复,从中正中开胸和MICS获得的经验直接应用于机器人手术。即使在复杂瓣膜修复病例中,机器人辅助手术也能增强手术视野的可视化并提高可操作性。在本文中,我将描述手术创新、体外循环的安全建立、手术结果以及机器人辅助瓣膜修复术目前为实现安全和改善效果所面临的挑战。

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