如何安全稳妥地为患者实施心脏手术一直都是各国医学家们研究的项目。英国医学家日前就找到了一种实施心脏手术的新方法。利用一种新研发的软件系统,外科医生无需非要在患者心跳暂停或是心跳减慢时才能对其实施手术,不久后,在砰砰跳动的心脏上实施手术将成为可能。
曾经--心脏在手术中需要暂停跳动
据英国《每日邮报》2月27日报道,通常,在心脏搭桥手术中,医生会使患者的心脏暂时停止跳动,以便在上面进行手术。同时,医生会使用一个人造泵来维持患者体内的血液流通。现在有些医学家为了避免上述这种高创伤性的程序,便在手术中使用了另外一种方法。他们并没有让患者的心脏暂时停止跳动,而是通过冷却的方法使其跳动速度减慢。但即使这样,他们也要在一个"活动的目标"上实施手术。对此,伦敦帝国学院的外科医生拉杰什·阿加尔瓦尔表示:"在固定的心脏组织上进行手术就已经是件难事了,更别提当它运动的时候了。"
以后--在跳动的心脏上做手术成为可能
这种新方法其实是使用一种名为 "运动补偿"的软件系统(Motion compensation software)。"运动补偿"软件的主要研发者是伦敦帝国学院的乔治·米洛纳斯。上文提到的拉杰什·阿加尔瓦尔也是该软件的研发人员之一。这个软件系统可以让心脏手术中使用到的机器人工具与病人的心脏运动状态相一致,这样医生们就能在病人的心脏仍旧正常跳动的情况下来实施手术。
报道说,和这种软件系统一起使用的是达芬奇机器人(da Vinci robot),这种外科手术机器人拥有装备着两个照相机的内窥镜,可以向外科医生提供患者手术部位的图像。该软件系统会建立一个患者心脏的3维模型,而这个模型看起来则是固定不动的。同时,它还能记录下患者的心跳,并吩咐达芬奇机器人随着患者心脏的跳动向前或向后移动。这样,医生就能在患者的心脏依然跳动且胸腔不被打开的情况下进行手术。
到目前为止,这种软件只通过一个机械手臂在一个人造心脏上进行过试验。但是,它未来的前景十分广阔。
(国际在线独家资讯 王高山)
Surgeons could soon perform heart surgery without missing a beat. Scientists have devised a way that robotic tools can match the movement of the heart making it possible to operate without stopping or even slowing the heart beat.
Usually in bypass surgery, the heart is stopped and an artificial pump is used to keep blood flowing around the body. Some scientists now avoid this highly traumatic procedure and slow the heart down by cooling it, but operate on a "moving target."
"It's a difficult procedure on a stationary piece of tissue, let alone when it is moving," surgeon Rajesh Aggarwal, one of the software developers from Imperial College London said.
The new software synchronises the movement of the robotic tools with the heart's beat, according to a New Scientist report.
It is used with the da Vinci robot, which has a two-camera endoscope that feeds images to the surgeon. The software constructs a 3D model of the heart which appears stationary. It also records the beating of the heart and tells the robotic tool to move backwards and forwards.
This could allow surgeons to operate with the chest closed.
So far the software, developed by George Mylonas at Imperial, has only been tested on an artificial heart using a robotic arm.
It was presented at the Medical Device Technology conference in Birmingham.