Melvin W Scott, Needleman Bradley J, Krause Kevin R, Schneider Carol, Ellison E Christopher
Department of Surgery and the Center for Minimally Invasive Surgery, The Ohio State University School of Medicine and Public Health, Columbus, OH 43210, USA.
J Gastrointest Surg. 2002 Jan-Feb;6(1):11-5; discussion 15-6. doi: 10.1016/s1091-255x(01)00032-4.
Computer-assisted telesurgical devices have recently been approved in the United States for general surgery. To determine the safety and efficacy of these procedures, we performed a prospective trial of computer-enhanced "robotic" fundoplication compared to standard laparoscopic control procedures. Consecutive patients undergoing surgical treatment for gastroesophageal reflux were included. The operating surgeon worked at a console using a three-dimensional image and manipulated hand controls. Operative times, complications, and length of hospital stay were recorded. A standardized questionnaire was administered to evaluate symptoms. Twenty patients were entered into each group. There were no differences in age, preoperative weight, or sex. Operative times were significantly longer in the robot group (97 vs. 141 minutes). There were no complications and most patients went home the first postoperative day. At follow-up, symptoms were similar in both groups; however, there was a significant difference in the number of patients taking antisecretory medication--none in the robotic group but six in the laparoscopic group reported regular use. Computer-assisted laparoscopic antireflux surgery is safe. However, operative times are longer, with little difference in outcomes. At the current level of technology and experience, robotic antireflux surgery appears to offer little advantage over standard laparoscopic approaches.
计算机辅助远程手术设备最近在美国已被批准用于普通外科手术。为了确定这些手术的安全性和有效性，我们进行了一项前瞻性试验，将计算机增强的“机器人”胃底折叠术与标准腹腔镜对照手术进行比较。纳入了因胃食管反流接受手术治疗的连续患者。主刀医生在控制台使用三维图像并操作手动控制器。记录手术时间、并发症和住院时间。采用标准化问卷评估症状。每组纳入20例患者。两组患者在年龄、术前体重或性别方面无差异。机器人组的手术时间明显更长（97分钟对141分钟）。无并发症发生，大多数患者术后第一天就回家了。随访时，两组症状相似；然而，服用抗分泌药物的患者数量有显著差异——机器人组无患者报告规律使用，而腹腔镜组有6例患者报告规律使用。计算机辅助腹腔镜抗反流手术是安全的。然而，手术时间更长，结果差异不大。在当前的技术和经验水平下，机器人抗反流手术似乎比标准腹腔镜手术优势不大。
