Binder J, Jones J, Bentas W, Wolfram M, Bräutigam R, Probst M, Kramer W, Jonas D
Klinik für Urologie und Kinderurologie, Klinikum, Johann-Wolfgang-Goethe Universität Frankfurt am Main.
Urologe A. 2002 Mar;41(2):144-9. doi: 10.1007/s00120-002-0178-2.
Complex reconstructive laparoscopic procedures in the field of urology such as radical prostatectomy and pyeloplasty have attracted increased attention in the past 2 years. However, extensive laparoscopic experience is required to master these procedures. Therefore, it remains questionable whether these techniques, which have been shown to be of profit to the patient in the hands of a specialist, will achieve widespread distribution. We have employed computer technology to bridge the gap between open surgery and laparoscopic access and used the daVinci Surgical System to establish laparoscopic radical prostatectomy as well as pyeloplasty and other retroperitoneal procedures at our institution. With experience of more than 70 procedures, we find that with the assistance of the daVinci Surgical System both radical prostatectomy and retroperiteoneal procedures can be easily translated from open to minimally invasive procedures with a considerably shorter learning curve and without compromising patient safety. We expect that large incisions will be soon a thing of the past in urologic surgery. Computer technology, together with mechanical engineering, will play a major role in enabling us to achieve better results despite minimal invasiveness.
过去两年里,泌尿外科领域的复杂重建性腹腔镜手术,如根治性前列腺切除术和肾盂成形术,已引起越来越多的关注。然而,掌握这些手术需要丰富的腹腔镜手术经验。因此,这些在专家手中已被证明对患者有益的技术能否广泛应用,仍值得怀疑。我们利用计算机技术弥合开放手术与腹腔镜手术之间的差距,并在我们机构使用达芬奇手术系统开展腹腔镜根治性前列腺切除术、肾盂成形术及其他腹膜后手术。通过70多例手术的经验,我们发现,在达芬奇手术系统的辅助下,根治性前列腺切除术和腹膜后手术都能轻松地从开放手术转变为微创手术,学习曲线显著缩短,且不影响患者安全。我们预计,大切口手术在泌尿外科手术中很快将成为历史。计算机技术与机械工程将发挥重要作用,使我们能够在微创的情况下取得更好的效果。