Lee Richard S, Borer Joseph G
Department of Urology, Children's Hospital Boston, MA 02115, USA.
Curr Opin Urol. 2006 Jul;16(4):291-4. doi: 10.1097/01.mou.0000232052.74342.a0.
Robotic surgery for ureteropelvic junction obstruction is an evolving technique. We review the current literature related to this technique and discuss the current technique and outcomes of robotic pyeloplasty.
Recent advances in robotic-assisted surgery have allowed the successful completion of complex reconstructive procedures in the pediatric population, including the robotic-assisted laparoscopic pyeloplasty. Robotic-assisted laparoscopic pyeloplasty can be performed by either a transperitoneal or a retroperitoneal approach. Overall, the procedure is safe, efficacious, and may have particular benefits over open surgery.
The evolution of laparoscopic surgery in pediatric urology has been limited by the challenge of laparoscopic suturing. Robotic systems may offer the means to overcome this major impediment of laparoscopic surgery. The results of this review demonstrate that robotic-assisted laparoscopic pyeloplasty is safe, technically feasible, and efficacious in the pediatric population, and may be comparable to a contemporary series of open pyeloplasty. As the technology continues to evolve, the efficiency of the robotic system is likely to improve; however, the ultimate role of robotic-assisted or computer-assisted surgical systems remains unclear. To further determine the role of robotic systems in the management of ureteropelvic junction obstruction, rigorous prospective research is needed that combines surgical and technical outcomes with overall subjective or cosmetic outcome and economic analysis.
机器人手术治疗肾盂输尿管连接部梗阻是一项不断发展的技术。我们回顾了与该技术相关的当前文献，并讨论了机器人肾盂成形术的当前技术和结果。
机器人辅助手术的最新进展已使儿科人群中的复杂重建手术得以成功完成，包括机器人辅助腹腔镜肾盂成形术。机器人辅助腹腔镜肾盂成形术可通过经腹或腹膜后途径进行。总体而言，该手术安全、有效，与开放手术相比可能具有特殊优势。
小儿泌尿外科腹腔镜手术的发展受到腹腔镜缝合挑战的限制。机器人系统可能提供克服腹腔镜手术这一主要障碍的方法。本综述结果表明，机器人辅助腹腔镜肾盂成形术在儿科人群中安全、技术上可行且有效，可能与当代一系列开放肾盂成形术相当。随着技术不断发展，机器人系统的效率可能会提高；然而，机器人辅助或计算机辅助手术系统的最终作用仍不明确。为进一步确定机器人系统在肾盂输尿管连接部梗阻治疗中的作用，需要进行严谨的前瞻性研究，将手术和技术结果与总体主观或美容结果以及经济分析相结合。
