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Abstract：
Background/Objectives: Robotically assisted mitral valve (MV) surgery is the least invasive surgical approach to the MV. The aim of the present study is to report our experience with robotically assisted MV repair, trying to define how experience could impact on postoperative results. Methods: This is a retrospective study on 144 patients who underwent robotic MV repair from November 2011 to March 2023. Patients were divided in two groups: Group 1, including 39 patients (November 2011-January 2013) operated using the Da Vinci Si system, and Group 2, including 105 patients operated (February 2020-March 2023) using the new Da Vinci Xi system. Results: Mean age was 58 ± 10 years. Increased use of external aortic clamp was observed in Group 2. A significant reduction of surgical times was observed: cardiopulmonary bypass time was 155 ± 44 min in Group 1 and 121 ± 36 min in Group 2 (p = 0.002), whereas cross-clamp time was 112 ± 25 min in Group 1 and 68 ± 39 min in Group 2 (p < 0.001). In-hospital mortality was 0.7%, and 10-year survival was 96 ± 2%. Freedom from reoperation was 100%. A higher percentage of complex and most complex MV repairs were performed in Group 2 (36% in Group 1 vs. 52% in Group 2, p = 0.001). Conclusions: Robotic-assisted MV repair is associated with excellent results. Experience is a key element to overcome the limitations of this technology. Finally, the robotic platform could improve results in difficult MV repair.
摘要：
背景/目的：机器人辅助二尖瓣（MV）手术是MV侵入性最小的手术方法。本研究的目的是报告我们在机器人辅助MV修复方面的经验，试图定义经验如何影响术后结果。方法：这是一项对2011年11月至2023年3月接受机器人MV修复的144例患者的回顾性研究。患者分为两组：第1组，包括39例患者（2011年11月至2013年1月）使用达芬奇Si系统进行手术，和第2组，包括105名患者（2020年2月至2023年3月）使用新的达芬奇Xi系统进行手术。结果：平均年龄58±10岁。在第2组中观察到外部主动脉钳的使用增加。观察到手术时间显着减少：第1组的体外循环时间为155±44分钟，第2组的体外循环时间为121±36分钟（p=0.002），而交叉钳夹时间1组为112±25分钟,2组为68±39分钟(p<0.001)。住院死亡率为0.7%，10年生存率为96±2%。再次手术的自由是100%。在第2组中进行了较高比例的复杂和最复杂的MV修复（第1组中36％与组2中为52%，p=0.001)。结论：机器人辅助MV修复具有良好的效果。经验是克服这项技术局限性的关键因素。最后,机器人平台可以改善难以修复的MV结果。
