Robotic cardiac surgery by 2031.

摘要

Robotic cardiac surgery started in 1997 with the use of a simple, voice-activated, camera-positioning robot (Aesop™).1 Early mitral valve repairs were performed in Paris and Leipzig with use of a prototype of the da Vinci™ surgical system (Intuitive Surgical, Inc.; Sunnyvale, Calif). In the United States, our group purchased the first da Vinci system in 1999, and in 2000 we began robotic mitral valve trials that led to the approval of the system by the U.S. Food and Drug Administration.2 Since then, our unit has performed nearly 700 robotic mitral valve repairs.3,4 This platform has been adopted, with excellent results, by several major centers that now have extensive experience.5 Up-to-date series have proved that durable, complex repairs can be made with acceptable perfusion and arrest times and with low mortality and complication rates. Robotic coronary surgery has not achieved the same level of success or adoption as has mitral valve surgery. Robotic coronary operations are more difficult to perform, and internal thoracic graft patency has not met the open-chest standard. Moreover, the development of efficient arterial connectors has not come to fruition. Finally, on-table graft patency is more difficult to determine with the use of transesophageal echocardiography than is the success of mitral surgery. Nevertheless, several centers perform robotic coronary surgery very well.6