Weber Philip A, Merola Stephen, Wasielewski Annette, Ballantyne Garth H
Minimally Invasive & Telerobotic Surgery Institute, Hackensack University Medical Center, New Jersey 07601, USA.
Dis Colon Rectum. 2002 Dec;45(12):1689-94; discussion 1695-6. doi: 10.1007/s10350-004-7261-2.
Telerobotic surgical systems attempt to provide technological solutions to the inherent limitations of traditional laparoscopic surgery. In this article, we present the first two reported cases of telerobotic-assisted laparoscopic colectomies performed on March 6 and 8, 2001.
In the first patient we performed a telerobotic-assisted laparoscopic sigmoid colectomy for diverticulitis. In the second patient, we accomplished a telerobotic-assisted laparoscopic right hemicolectomy for cecal diverticulitis. The Da Vinci telerobotic surgical system was used in both cases to mobilize the bowel. The mesenteric division, bowel transection, and anastomoses were accomplished with standard laparoscopic-assisted techniques. Both operations were completed with a three-trocar technique.
We found that the Da Vinci system adequately replaced the camera holder. The three-dimensional virtual operative field helped to maintain the surgeon's orientation during the operation. The combination of three-dimensional imaging and the hand-like motions of the telerobotic surgical instruments facilitated dissection. The Da Vinci console offered an ergonomically comfortable position for the surgeon. Operative times for the sigmoid colectomy was 340 minutes and for the right hemicolectomy 228 minutes. Telerobotic-assisted laparoscopic colectomy is feasible, but required a longer operative time than our standard laparoscopic-assisted technique.
Telerobotic-assisted laparoscopic colectomy is feasible and warrants further investigations in controlled trials.
远程机器人手术系统试图为传统腹腔镜手术的固有局限性提供技术解决方案。在本文中，我们介绍了2001年3月6日和8日进行的首例两例远程机器人辅助腹腔镜结肠切除术的报道病例。
在第一例患者中，我们为憩室炎进行了远程机器人辅助腹腔镜乙状结肠切除术。在第二例患者中，我们为盲肠憩室炎完成了远程机器人辅助腹腔镜右半结肠切除术。两例均使用达芬奇远程机器人手术系统来游离肠管。肠系膜离断、肠管横断和吻合均采用标准的腹腔镜辅助技术完成。两台手术均采用三孔技术完成。
我们发现达芬奇系统充分替代了持镜器。三维虚拟手术视野有助于术者在手术过程中保持方向。三维成像与远程机器人手术器械类似手的动作相结合便于解剖操作。达芬奇控制台为术者提供了符合人体工程学的舒适体位。乙状结肠切除术的手术时间为340分钟，右半结肠切除术为228分钟。远程机器人辅助腹腔镜结肠切除术是可行的，但与我们的标准腹腔镜辅助技术相比需要更长的手术时间。
远程机器人辅助腹腔镜结肠切除术是可行的，值得在对照试验中进一步研究。
