Pigazzi A, Ellenhorn J D I, Ballantyne G H, Paz I B
Minimally Invasive Surgery Program, Division of General Oncologic Surgery, City of Hope National Cancer Center, 1500 East Duarte Road, Duarte, California 91010, USA.
Surg Endosc. 2006 Oct;20(10):1521-5. doi: 10.1007/s00464-005-0855-5. Epub 2006 Aug 1.
With advanced stereoscopic vision, lack of tremor, and the ability to rotate the instruments surgeons find that robotic systems are ideal laparoscopic tools. Because of its high operating cost, however, robotic surgery should be reserved to procedures in which the technology can be of maximum benefit, usually when precise dissections in confined spaces are required. Because conventional laparoscopic total mesorectal excision is a challenging procedure, we have sought to assess the utility of the DaVinci robotic system in laparoscopic low anterior resections for cancer of the rectum.
Between November 2004 and May 2005 robotic-assisted low anterior resection with total mesorectal excision was performed on six consecutive patients with rectal cancer. These cases were compared with six consecutive low anterior resections performed with conventional laparoscopic techniques by the same surgeon.
There were no conversions in either group. Operative and pathological data, complications, and hospital stay were similar in the two groups. Robotic operations appeared to cause less strain for the surgeon.
Robotic-assisted laparoscopic low anterior resection for rectal cancer is feasible in experienced hands. This technique may facilitate minimally invasive radical rectal surgery.
凭借先进的立体视觉、无震颤以及器械可旋转的特性，外科医生发现机器人系统是理想的腹腔镜手术工具。然而，由于其高昂的操作成本，机器人手术应仅限于该技术能带来最大益处的手术，通常是在需要在狭窄空间进行精确解剖时。由于传统腹腔镜全直肠系膜切除术是一项具有挑战性的手术，我们试图评估达芬奇机器人系统在腹腔镜直肠癌低位前切除术中的效用。
2004年11月至2005年5月期间，对6例连续性直肠癌患者实施了机器人辅助低位前切除术并进行全直肠系膜切除。将这些病例与同一位外科医生采用传统腹腔镜技术连续进行的6例低位前切除术进行比较。
两组均无中转开腹情况。两组的手术及病理数据、并发症和住院时间相似。机器人手术似乎给外科医生带来的压力较小。
在经验丰富的医生手中，机器人辅助腹腔镜直肠癌低位前切除术是可行的。该技术可能有助于微创根治性直肠手术。
