摘要
目的总结利用＂达芬奇＂机器人系统完成二尖瓣手术的临床经验及安全性。方法回顾性分析解放军总医院于2007年3月~2010年12月完成的机器人微创二尖瓣手术60例的临床资料,包括二尖瓣成形44例,二尖瓣置换16例。术中食道超声引导下,股动静脉及右侧颈内静脉插管建立体外循环。于右侧胸壁打直径为0.8 cm的器械臂孔3个,直径为1.5 cm工作孔1个,术者于操作台前、三微成像系统下遥控微创器械行二尖瓣成形或置换。术后即刻食道超声评估手术效果。术后常规进行随访。结果无手术死亡及中术式转化。二尖瓣成形平均体外循环时间（132.2±29.6）min,主动脉阻断时间（88.1±22.3）min;二尖瓣置换平均体外循环时间（137.1±21.9）min,主动脉阻断时间（99.3±17.4）min。平均随访时间为（14.2±9.3）月,2例二尖瓣成形患者术后轻度反流。结论机器人系统对二尖瓣结构暴露效果好,可安全、有效的完成二尖瓣成形及置换,是可供选择的微创术式之一。
Objective To evaluate the safety and efficacy of robotic mitral valve surgery using da Vinci S system.Method We conducted a retrospective review of 60 robotic mitral surgeries from March 2007 to December 2010.Of the 60 patients,44 underwent mitral valve repair and 16 received mitral valve replacement.The surgical approach was through 4 right chest ports with femoral and internal jugular vein cannulations.Transesophageal echocardiography was used intraoperatively to estimate the surgical results.Results None of the cases required a conversion to a median sternotomy.The mean cardiopulmonary bypass and cardiac arrest time was 132.2±29.6 min and 88.1±22.3 min for robotic mitral valve repair,and was 137.1±21.9 min and 99.3±17.4 min for robotic mitral valve replacement.Echocardiographic follow-up of all the patients revealed 3 cases of slight regurgitation in mitral valve repair group.Conclusion In selected patients with mitral valve disease,robotic mitral surgery can be performed safely.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2011年第10期1721-1723,共3页
Journal of Southern Medical University
基金
2007年首都医学发展基金(2007-2041)
全军"十一五"科技公关(08G138)
2010军队临床高新技术重大项目(2010GXJS086)
关键词
机器人
二尖瓣手术
微创手术
robotics
mitral valve surgery
minimally invasive surgery
