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題 名 | Robot Assisted Left Internal Thoracic Artery Harvesting in Minimally Invasive Direct Coronary Artery Bypass: Report of a Case=使用機器人輔助摘取左側內腔動脈進行微創冠狀動脈繞道手術:病例報告 |
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作 者 | 李志賢; 洪國峻; 蔡宜廷; 林致源; 李中毅; 陽厚生; 蔡建松; | 書刊名 | 臺灣外科醫學會雜誌 |
卷 期 | 39:4 民95.08-09 |
頁 次 | 頁205-209 |
分類號 | 416.3 |
關鍵詞 | 冠狀動脈繞道手術; Cardiac surgery; LITA; MIDCABG; Robotic surgery; |
語 文 | 英文(English) |
中文摘要 | 傳統的冠狀動脈繞道手術通常都使用胸骨正中切開術,在發展微創冠狀動脈繞道手術受限於內視鏡器械的靈活度,無法精確縫合冠狀動脈。達文西系統提供三度空間;靈活度;穩定性可改善傳統內視鏡的缺點。我們在此報告一位76歲男性,診斷為冠狀動脈疾病併左前降支冠狀動脈90%狹窄。我們使用機器人輔助取得內乳動脈,經左前胸切入使用不停跳方式行冠狀動脈繞道手術。術後追蹤六個月病人恢復狀況良好。 |
英文摘要 | Coronary artery bypass grafting (CABG) is usually performed through a sternotomy. Minimally invasive direct coronary artery bypass grafting (MIDCABG) has been used recently in a select group of patients with severe lesions of the left anterior descending (LAD) coronary artery. CABG has been proven difficult to adapt to a totally endoscopic approach because of the inability to perform a precision microvascular-sutured coronary anastomosis with conventional endoscopic instrumentation. The Da Vinci telemanipulation system has six degrees of freedom and allows free orientation in space and a remote, tremor-free, three-dimensional visual image. We report hereby a 76-year-old male who suffered from substernal chest pain that radiated to the left shoulder for one day. Coronary angiography confirmed coronary artery disease with 90% occlusion of the LAD coronary artery. The patient volunteered to receive the operation. Robotically assisted left internal thoracic artery (LITA) harvesting and direct off-pump anastomosis to the LAD through small thoracotomy incisions were performed safely. The patient improved clinically and was free of angina at the six-month follow-up. We describe an alternative procedure for one-vessel disease using robotic takedown of the LITA and off-pump anastomosis to the LAD artery through small incisions. This procedure is associated with minimal blood loss and ventilatory requirements, and short stays in the intensive care unit and hospital. |
本系統中英文摘要資訊取自各篇刊載內容。