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[用于腹部手术的机器人及远程机器人手术系统]

[Robotic and telerobotic surgical systems for abdominal surgery].

作者信息

Córdova Dupeyrat Alfredo, Ballantyne Garth H

机构信息

Hospital Nacional Arzobispo Loayza, Facultad de Medicina Humana USMP, Lima, Perú.

出版信息

Rev Gastroenterol Peru. 2003 Jan-Mar;23(1):58-66.

Abstract

The United States Food and Drug Administration (FDA) has approved four robotic surgical systems to be used in operations of clinical laparoscopy. The purpose of this article is to describe these four robotic surgical systems. In robotic laparoscopy surgery, AESOP and Endoassist replace the cameraman and provide a stable platform for the video telescope. AESOP is controlled by the surgeon's voice commands, whereas Endoassist responds to the movements of an infrared light adhered to the surgeon's head. During the telerobotic laparoscopic surgeries, the physician is seated in front of a computer console that is at a distance from the patient. The surgeon observes a virtual three-dimensional operating area and carries out the operation by controlling two tele-robotic arms, both of which hold the surgical instruments. These telerobotic arms simulate the movements of the surgeon's hands, with six degrees of freedom and two degrees of axial rotation. By combining the three-dimensional images and the movements which are similar to the manual movements of the surgical instruments, The complex laparoscopic procedures are facilitated. In June 2000, the tele-robotic surgical system Da Vinci was authorized by the FDA to act as an operating surgeon, but in October 2001, in the case of Zeus, it was only authorized to act as an assistant surgeon during laparoscopies,. Consequently, surgeons have reported great clinical experiences with Da Vinci. Tele-robotic, laparoscopic abdominal surgery is feasible, and its initial results are similar to those obtained from traditional laparoscopic surgery. Therefore, the tele-robotic and robotic surgical systems overcome some of the limitations inherent in traditional laparoscopic surgeries and they could increase the number of surgeons who could perform complex laparoscopies in the future.

摘要

美国食品药品监督管理局(FDA)已批准四种机器人手术系统用于临床腹腔镜手术。本文旨在介绍这四种机器人手术系统。在机器人腹腔镜手术中,AESOP和Endoassist取代了摄像师,并为视频望远镜提供了一个稳定的平台。AESOP由外科医生的语音指令控制,而Endoassist则响应附着在外科医生头部的红外光的移动。在远程机器人腹腔镜手术中,医生坐在距离患者有一定距离的计算机控制台前。外科医生观察虚拟的三维手术区域,并通过控制两个远程机器人手臂来进行手术,这两个手臂都握着手术器械。这些远程机器人手臂模拟外科医生手部的动作,具有六个自由度和两个轴向旋转度。通过将三维图像与类似于手术器械手动动作的动作相结合,复杂的腹腔镜手术变得更加容易。2000年6月,远程机器人手术系统达芬奇被FDA批准可作为主刀医生,但在2001年10月,对于宙斯系统,它仅被批准在腹腔镜手术中作为助手医生。因此,外科医生报告了使用达芬奇系统的丰富临床经验。远程机器人腹腔镜腹部手术是可行的,其初步结果与传统腹腔镜手术相似。因此,远程机器人和机器人手术系统克服了传统腹腔镜手术固有的一些局限性,并且它们可能会增加未来能够进行复杂腹腔镜手术的外科医生数量。

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