Wei Lawrence M, Badhwar Vinay
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.
Ann Cardiothorac Surg. 2025 May 31;14(3):228-234. doi: 10.21037/acs-2025-ravr-12. Epub 2025 May 29.
The application of robotic cardiac surgery has long been considered the pinnacle of surgical care for an isolated procedure. This has been for good reason, as the quality and reproducibility of isolated procedures like mitral valve (MV) repair and robotic-assisted, minimally invasive, direct coronary artery bypass have grown steadily across the globe with shrinking learning curves. Once a robotic team's learning curve has crested, however, additional opportunities may be explored that may include concomitant procedures. Following the core surgical principles of safety and procedural homogeneity with open operations, robotic cardiac surgery may be extended in a stepwise fashion to multi-valve operations, concomitant maze procedures, aortic root enlargement, septal myectomy, and even valve and coronary bypass operations, all via the same transaxillary working incision. We will review the development and operative techniques of concomitant procedures that may be utilized in conjunction with robotic aortic valve replacement (RAVR).
长期以来，机器人心脏手术的应用一直被视为单一手术的外科护理巅峰。这是有充分理由的，因为像二尖瓣修复和机器人辅助、微创、直接冠状动脉搭桥等单一手术的质量和可重复性在全球范围内随着学习曲线的缩短而稳步提高。然而，一旦机器人手术团队的学习曲线达到顶峰，就可以探索其他机会，这可能包括联合手术。遵循与开放手术相同的安全和手术同质性核心手术原则，机器人心脏手术可以逐步扩展到多瓣膜手术、联合迷宫手术、主动脉根部扩大、室间隔心肌切除术，甚至瓣膜和冠状动脉搭桥手术，所有这些都通过相同的经腋窝工作切口进行。我们将回顾可与机器人主动脉瓣置换术（RAVR）联合使用的联合手术的发展和手术技术。
