Byrd Catherine T, Balakrishnan Karthik, Holsinger F Christopher, Ma Michael R, Janus Jeffrey R, Guo H Henry, Lui Natalie S
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
Ann Thorac Surg Short Rep. 2023 Dec 6;2(1):103-107. doi: 10.1016/j.atssr.2023.11.016. eCollection 2024 Mar.
Pediatric long-segment tracheal stenosis often requires operative repair with a slide tracheoplasty performed through median sternotomy. We hypothesized that this operation can be performed through a transcervical approach with use of a single-port robotic system.
A transcervical single-port robotic slide tracheoplasty was performed in 2 models-a 3-dimensional (3D) printed pediatric tracheal stenosis model and a cadaveric pig trachea model.
Single-port robotic slide tracheoplasty was successfully performed in both models. They were large enough that there were minimal issues with limited working space, although mediastinal structures around the trachea were not represented in the models. The advantage of the 3D printed model was the realistic anatomic tracheal stenosis; the advantage of the pig trachea model was the realistic tissue.
Transcervical single-port robotic slide tracheoplasty was technically feasible in both our 3D printed and pig trachea models. However, given the limited working space, there are limits to the size of the patient for this technique. Further development is needed before this technique is ready for clinical use.
小儿长段气管狭窄通常需要通过正中胸骨切开术进行滑动气管成形术来进行手术修复。我们推测该手术可以通过使用单端口机器人系统的经颈入路来完成。
在两个模型中进行了经颈单端口机器人滑动气管成形术——一个三维(3D)打印的小儿气管狭窄模型和一个尸体猪气管模型。
在两个模型中均成功进行了单端口机器人滑动气管成形术。它们足够大,工作空间有限的问题最小,尽管气管周围的纵隔结构在模型中未体现。3D打印模型的优点是逼真的解剖学气管狭窄;猪气管模型的优点是逼真的组织。
经颈单端口机器人滑动气管成形术在我们的3D打印模型和猪气管模型中在技术上都是可行的。然而,鉴于工作空间有限,该技术适用的患者体型存在限制。在该技术准备好用于临床之前,还需要进一步发展。