Minim Invasive Ther Allied Technol. 2001 Nov;10(6):283-288. doi: 10.1080/136457001753337320.
Endoscopic surgery has rapidly changed the performance of surgical procedures in a wide range of surgical specialities, but difficulties with endoscopic manipulation remain. The next step in the revolution initiated by the introduction of endoscopic surgery will be achieved by the introduction of robotics, tele-mentoring systems and telepresence surgery. Primary capabilities brought to surgery by robotic manipulators can be summarised as surgical assistance, image-guided therapy and dexterity enhancement. Using computer-aided systems, such as robotics and image-guided surgery, the next generation of surgical systems will be more sophisticated, and will permit surgeons to perform surgical procedures beyond the current limitation of human performance — on the microscale, or on moving organs. Industry is focusing currently on developing manipulators for endoscopic microsurgery, and several devices have already entered clinical use. Taking advantage of one such robotic system, we have developed a new method of endoscopic cholecystectomy, which is performed without leaving foreign bodies and using a procedure that prevents adhesions after surgery. Some new endoscopic procedures have also become feasible, although these are currently performed only by open surgery, without this system. It seems to be highly probable that master–slave manipulators will soon be in routine surgical use for selected indications.
内镜手术已迅速改变了众多外科专业领域手术操作的方式，但内镜操作仍存在困难。由内镜手术引入所引发的这场革命的下一步将通过引入机器人技术、远程指导系统和远程临场手术来实现。机器人操纵器为手术带来的主要能力可概括为手术辅助、图像引导治疗和灵活性增强。利用机器人技术和图像引导手术等计算机辅助系统，下一代手术系统将更加精密复杂，并且将使外科医生能够超越当前人类操作的局限进行手术——在微观层面或对运动器官进行手术。目前业界正专注于开发用于内镜显微手术的操纵器，已有几种设备进入临床应用。利用这样一种机器人系统，我们开发了一种新的内镜胆囊切除术方法，该方法在不遗留异物的情况下进行，且采用了一种防止术后粘连的手术方式。一些新的内镜手术也已变得可行，尽管目前这些手术仅通过开放手术进行，尚未使用该系统。主从操纵器很可能很快会在某些特定适应证的常规手术中得到应用。
