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Robotic Mitral Valve Repair using da Vinci Surgical System – Initial Experience
연세대학교 의과대학 흉부외과학교실
박한기, 이삭, 박성용, 양홍석, 장병철
Objective: Computerized surgical robotic system enabled complicated intracardiac procedures through minimal invasive approach, and now robotic cardiac surgery has been established as a standard surgical approach in some institutes. But, starting robotic surgery can be a big challenge for surgeons who have no experience. We report our initial experience with robotic cardiac surgery using da VinciTM Surgical System. Material and Methods: Eleven patients (median age, 43 years) underwent robotic mitral valve repair. All patients had moderate to severe mitral insufficiency. Atrial septal defect was combined in a patient. Operative techniques include peripheral cardiopulmonary bypass, a 4 cm mini-thoracotomy, transthoracic aortic occlusion, and antegrade cardioplegia through cannula inserted into ascending aorta. Intracardiac repair was performed with da VinciTM Surgical System. Results: The mitral valve was repaired with neo-chordae formation, leaflet defect repair, triangular resection and ring annuloplasty technique. Median cardiopulmonary bypass time was 239 (149 - 272) minutes and aorta cross-clamp time was 151 (99 - 203) minutes. There was no incisional conversion. There was no operative mortality. In two patients, reoperation was required due to bleeding. No other complication developed after operation. In six patients, the endotracheal tube could be removed at the operating room after operation. Postoperative mitral regurgitation was grade I/IV in 3 patients, and less than trivial in the other patients. Conclusion: Robotic cardiac surgery can be performed safely by surgeons who had no robotic surgery experience. Various kinds of technique can be performed with da VinciTM system and the surgical outcome was excellent.


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