新颖的牵引器-摄像头系统有助于减少微创手术的创伤并简化手术视野。

Faizus Sazzad, Wee Han Ng, Gao Feng, Irwan Shah Bin Mohd Moideen, Abdulrahman El Gohary, Ki Han Kim, John C Stevens, Theo Kofidis
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引用次数: 0

摘要

目的开发一种新型内窥镜系统,为微创心脏瓣膜手术中的外科医生减少对患者的创伤并简化手术视野:我们设计并开发了一种用于微创心脏手术的牵开器-相机组合;电缆和相机连接到左心房牵开器刀片的底部,以提供二尖瓣的照明广角视图。我们对 20 名需要进行微创二尖瓣手术的患者进行了体外、体内试验,并最终进行了首次人体随机、非匿名临床试验。试验收集了患者术前和术后的数据,并对患者进行了为期 3 个月的随访:结果:在所有详细研究中,我们的相机-牵引器组合都显示出安全、高效的曝光和视野。干预组的总手术时间(316.5 ± 65.1 分钟)略短于对照组(317.5 ± 50.8 分钟)。对照组和试验组在暴露二尖瓣和左心房周围组织的能力上没有明显差异。新型照相机牵引器大大减少了手术区域的杂波,消除了照相机的胸部穿透。我们还观察到,摄像头不会起雾,不会沾染血液,也不需要经常校正位置:我们推出了一种新型心房牵引成像平台,该平台对患者的创伤更小,并消除了杂乱和多余动作对外科医生的影响。
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Novel Retractor-Camera System Facilitates Less Traumatic Minimally Invasive Procedures and Declutters the Operation Field.

Objective: To develop a novel endoscopic system that reduces trauma to the patient and declutters the surgical field for the surgeon in minimally invasive heart valve surgery.

Methods: We designed and developed a retractor-camera combination for minimally invasive heart surgery; the cable and camera were connected to the underbelly of the left atrial retractor blade to provide an illuminated, wide-angle view of the mitral valve. We conducted ex vivo, in vivo, and, ultimately, a first-in-man randomized, nonanonymized clinical trial on 20 patients who required minimally invasive mitral valve surgery. Data from the preoperative period and the immediate postoperative period were gathered, and patients were followed for 3 months.

Results: Our camera-retractor combo demonstrated safe and efficient exposure and vision in all detailed studies. The total operation time for the intervention group (316.5 ± 65.1 min) was slightly shorter than for the control group (317.5 ± 50.8 min). There was no significant difference in the ability to provide exposure of the mitral valve and surrounding left atrial tissue for both control and test articles. The novel camera-retractor reduced clutter in the operation field substantially and eliminated chest penetration for the camera. We also observed that the camera did not fog, did not stain with blood, and did not require frequent corrections to its position.

Conclusions: We launch a novel atrial retraction-imaging platform that is less invasive for the patient and eliminates clutter and redundant movements for the surgeon.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
期刊最新文献
Totally Endoscopic Coronary Artery Bypass Graft: Systematic Review and Meta-Analysis of Reconstructed Patient-Level Data. The 10 Commandments for State-of-the-Art Imaging of the Proximal Thoracic Aorta. Robot-Assisted Atrial Septal Defect Closure Via the Left Atrium: Dual Case Reports. The 10 Commandments of Endo-Bentall Repair. Innovative Surgical Left Atrial Appendage Closure Technique: Early Experience of Inverted Spiral Closure Technique.
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