Kariv Y, Delaney C P
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Minerva Chir. 2005 Oct;60(5):401-16.
A minimally invasive approach has not yet become the gold standard in colorectal procedures, despite its proven advantages in postoperative recovery. This is in part the result of the technical limitations in today's standard laparoscopy, and the advanced surgical skills that are required. Robotic technology overcomes some of these limitations by successfully providing intuitive motion and enhanced precision and accuracy, in an environment that is much more ergonomic. While currently performed in only few designated centers, this technology has already been applied in almost every major procedure performed to treat both benign and malignant conditions of the large bowel. The feasibility of performing these procedures using robotic systems has been reported in several series. Conversion and complication rates are low, and short term results are comparable to conventional laparoscopy. However, no clear advantages to patients have been demonstrated yet. Furthermore, robotic technology is associated with a significant increase in time consumed during surgery and cost of care. Nevertheless, a great potential for patients benefit in the future may exist with this technology. Increasing clinical experience with these systems, further technological developments, and continuous research are required before robotic technology can be routinely incorporated into surgical procedures on the colon and rectum.
尽管微创方法在术后恢复方面的优势已得到证实，但它尚未成为结直肠手术的金标准。这部分是由于当今标准腹腔镜手术存在技术限制，以及需要先进的手术技能。机器人技术通过在更符合人体工程学的环境中成功提供直观的动作、更高的精准度和准确性，克服了其中一些限制。虽然目前仅在少数指定中心开展，但这项技术已应用于几乎所有用于治疗大肠良恶性疾病的主要手术中。多个系列报道了使用机器人系统进行这些手术的可行性。中转率和并发症发生率较低，短期结果与传统腹腔镜手术相当。然而，尚未证明对患者有明显优势。此外，机器人技术会显著增加手术耗时和护理成本。尽管如此，这项技术未来可能给患者带来巨大益处。在机器人技术能够常规纳入结肠和直肠手术之前，需要增加对这些系统的临床经验、进一步的技术发展以及持续的研究。
