ロボット支援下心臓手術の諸考察

Various Considerations on Robot-assisted Cardiac Surgery

ある歴史家が革命について述べた言葉を借りると，“歴史というのは時折，突然あるものの内に凝縮されることを好むものであって，そこでは既存のものと新しいものが混ざり合い絶頂に達し，世界はそれから後，このものに追従する”．時代の転換期にはこういった革命的な何かが必ず出現することが知られている．筆者は心臓外科の領域においては，ロボットテクノロジーの出現がまさにこの革命的な事柄であると考えており，今後発展していく領域と確信している．

Robot-assisted cardiac surgery offers the most minimally-invasive approach to the surgical treatment of valvular heart disease and coronary artery disease. However, robot-assisted cardiac surgery is still far from being a standardized operation. We believe that with developing robotic technology, in the near future, robotic surgery will certainly play a key role in the field of cardiac surgery, thus tips and pitfalls for introducing robotic cardiac surgery and techniques of it should be described in more detail. After two years of our experience, we have performed about 200-cases of robot-assisted cardiac surgery, including robot-assisted mitral valve repair and minimally invasive coronary artery bypass grafting （CABG）. The safety and reliability of those procedures have been well described from outside Japan. However, in Japan, we are still standing at the dawn of the robot-assisted cardiac surgery era, thus various experiences should be published from each institution where the robot-assisted cardiac surgery has already standarized. Here we present our experiences and recent technical consideration of robot-assisted cardiac surgery using the da Vinci Xi surgical system.