Menciassi Arianna, Quirini Marco, Dario Paolo
Center for Research in Micro Engineering , CRIM Lab, Scuola Superiore SantAnna, Pisa, Italy.
Minim Invasive Ther Allied Technol. 2007;16(2):91-100. doi: 10.1080/13645700701266982.
The impulse given by robotic technologies and imaging techniques to the development of a new way to conceive and perform surgery is clearly visible. Nowadays, minimally invasive surgical (MIS) procedures are often performed with the assistance of robots, such as the Da Vinci master-slave system, the AESOP robot with voice control, etc. In addition, mechatronic technologies are becoming the elective technologies for designing advanced hand-held surgical tools. The introduction of robotic technologies in endoscopy has been slower than in MIS, since the development of miniaturized robotic components for entering the small orifices of the human body is difficult. On the other hand, the large contribution that robotic technologies could bring to endoluminal techniques has been evident since the first development of instrumented catheters. In the 1990s, there was an increasing activity in the application of robotic technologies to improve endoscopic procedures in the gastrointestinal tract. The objective of robotic colonoscopy and gastroscopy was to obtain more effective diagnoses in terms of reduced pain for the patients, and to make uniform the diagnostic procedures, which too often depended on the manual abilities of the endoscopist. Currently, the availability of more reliable robotic technologies for miniaturization of size and integration of functions has allowed to conceive and develop robotic pills for the early screening of the digestive tract, with dramatic potential advantages for patients, endoscopists, and healthcare system.
机器人技术和成像技术对构思和实施手术新方式发展所给予的推动作用清晰可见。如今,微创手术(MIS)程序常常在机器人辅助下进行,比如达芬奇主从系统、具有语音控制功能的AESOP机器人等。此外,机电一体化技术正成为设计先进手持式手术工具的首选技术。机器人技术在内窥镜检查中的应用发展比在微创手术中慢,因为开发用于进入人体小孔窍的小型化机器人部件很困难。另一方面,自仪器化导管首次研发以来,机器人技术能为腔内技术带来的巨大贡献就已很明显。在20世纪90年代,将机器人技术应用于改善胃肠道内窥镜检查程序的活动日益增多。机器人结肠镜检查和胃镜检查的目标是,在减轻患者疼痛方面获得更有效的诊断,并使诊断程序标准化,因为这些程序往往依赖于内镜医师的手工能力。目前,尺寸更小且功能集成度更高的更可靠机器人技术的出现,使得人们能够构思并开发用于消化道早期筛查的机器人药丸,这对患者、内镜医师和医疗保健系统具有巨大的潜在优势。