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首页> 外文期刊>Circulation journal >History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass
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History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

机译：机器人全内镜下冠状动脉旁路手术的历史和现状

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Robotic totally endoscopic coronary artery bypass (TECAB) is a minimally invasive endoscopic surgical approach using the daVinci robotic telemanipulation system to perform coronary artery bypass grafting on the arrested or beating heart. It is a procedure that can be a useful alternative to the classic open procedure performed through sternotomy. After extensive modeling in cadavers, the first clinical case was performed in June 1998 placing a left internal thoracic artery graft (LITA) to the left anterior descending artery completely robotically on the arrested heart. During the early and late 2000s, international groups have adopted this evolving technology, which has included iterations such as beating-heart TECAB, use of bilateral ITA grafting and radial artery grafting, as well as 3- and 4-vessel TECAB. TECAB is combined with percutaneous coronary intervention in hybrid procedures. Despite increasing complexity of endoscopic coronary bypass surgery, conversion rates to open bypass surgery have dropped significantly and operative times have decreased. Published major morbidities and mortality rates in arrested-and beating-heart TECAB have been cumulatively in the 0–2% range and are considered well within the expected range for these highly complex surgical procedures. Long-term survival and freedom from major adverse events also meet the standards of open bypass surgery. ( Circ J 2012; 76: 2058–2065)
机译：机器人完全内窥镜冠状动脉搭桥术（TECAB）是一种微创内窥镜手术方法，使用daVinci机器人远距操纵系统对停搏或跳动的心脏进行冠状动脉搭桥术。这是对通过胸骨切开术进行的经典开放手术的有用替代方法。在尸体上进行了广泛的建模之后，第一例临床病例于1998年6月进行，将左胸内动脉移植物（LITA）完全通过机械手完全放到了被捕心脏上的左前降支动脉上。在2000年代初期和后期，国际组织采用了这种不断发展的技术，其中包括诸如心脏跳动TECAB，使用双侧ITA移植和radial动脉移植以及3血管和4血管TECAB的迭代。 TECAB在混合手术中与经皮冠状动脉介入治疗相结合。尽管内窥镜冠状动脉搭桥手术的复杂性不断增加，但开放式搭桥手术的转化率已显着下降，手术时间减少了。已公布的心脏骤停和搏动中TECAB的主要发病率和死亡率已累计在0％至2％范围内，并被认为完全在这些高度复杂的外科手术的预期范围内。长期生存和不受重大不良事件影响也符合开放旁路手术的标准。 （Circ J 2012; 76：2058-2065）

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