市中病院でのロボット支援下僧帽弁形成術導入

Early Experience of Robot-assisted Mitral Valve Surgeries in Our Local Hospital

手術支援ロボットda Vinci（da Vinciサージカルシステム：Intuitive Surgical社，Sunnyvale）は，8 mmほどの細長いロボットアームや3Dカメラによって心臓内腔のような限られた空間でも手術操作ができ，われわれ心臓外科医にとって低侵襲心臓手術（MICS）が容易になると思われる．ただ心臓は常に動いている臓器であり，ロボットの操作には細心の注意が必要であり，ハードルも高い．

We report the early experience of robot-assisted mitral valve repair in our local hospital. It took about two years from the application for the robot-assisted cardiac surgery until the first case of robot-assisted mitral repair. Since July 2020 to June 2022, we have performed 23 cases of robot-assisted mitral valve repair with da Vinci Xi system. There was no hospital death. The mean cross-clamp and total operation time were 118±22 and 295±41 min, respectively. Pre-discharge echocardiograms showed none-to-mild residual mitral regurgitation （MR） in all patients. The mean post-operative hospital stay was 7.6±5 days.

Robot-assisted mitral valve repair could safely be started in our hospital. Early results were acceptable. Further experiences will be needed to confirm the efficacy of robotic mitral valve repair.