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机器人技术与普通外科手术。

Robotics and general surgery.

作者信息

Jacob Brian P, Gagner Michel

机构信息

Department of Surgery, Weill-Cornell College of Medicine 525 East 68th Street, New York, NY 10021, USA.

出版信息

Surg Clin North Am. 2003 Dec;83(6):1405-19. doi: 10.1016/S0039-6109(03)00159-2.

Abstract

Robotics are now being used in all surgical fields, including general surgery. By increasing intra-abdominal articulations while operating through small incisions, robotics are increasingly being used for a large number of visceral and solid organ operations, including those for the gallbladder, esophagus, stomach, intestines, colon, and rectum, as well as for the endocrine organs. Robotics and general surgery are blending for the first time in history and as a specialty field should continue to grow for many years to come. We continuously demand solutions to questions and limitations that are experienced in our daily work. Laparoscopy is laden with limitations such as fixed axis points at the trocar insertion sites, two-dimensional video monitors, limited dexterity at the instrument tips, lack of haptic sensation, and in some cases poor ergonomics. The creation of a surgical robot system with 3D visual capacity seems to deal with most of these limitations. Although some in the surgical community continue to test the feasibility of these surgical robots and to question the necessity of such an expensive venture, others are already postulating how to improve the next generation of telemanipulators, and in so doing are looking beyond today's horizon to find simpler solutions. As the robotic era enters the world of the general surgeon, more and more complex procedures will be able to be approached through small incisions. As technology catches up with our imaginations, robotic instruments (as opposed to robots) and 3D monitoring will become routine and continue to improve patient care by providing surgeons with the most precise, least traumatic ways of treating surgical disease.

摘要

机器人技术目前正应用于包括普通外科在内的所有外科领域。通过在小切口手术时增加腹腔内关节活动度,机器人技术越来越多地用于大量内脏和实体器官手术,包括胆囊、食管、胃、肠、结肠和直肠以及内分泌器官的手术。机器人技术与普通外科首次在历史上融合,作为一个专业领域在未来许多年应会持续发展。我们不断寻求解决日常工作中遇到的问题和局限性的方法。腹腔镜手术存在诸多局限性,如套管针插入部位的固定轴点、二维视频监视器、器械尖端灵活性有限、缺乏触觉以及某些情况下人体工程学不佳。创建具有三维视觉能力的手术机器人系统似乎能解决这些局限性中的大部分问题。尽管外科界一些人继续测试这些手术机器人的可行性并质疑如此昂贵项目的必要性,但其他人已经在设想如何改进下一代远程操作器,这样做时他们正展望未来以寻找更简单的解决方案。随着机器人时代进入普通外科医生的世界,越来越多复杂的手术将能够通过小切口进行。随着技术跟上我们的想象,机器人器械(相对于机器人)和三维监测将成为常规手段,并通过为外科医生提供治疗外科疾病最精确、创伤最小的方式,继续改善患者护理。

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