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机器人腹腔镜远端胃切除术:达芬奇系统与宙斯系统的比较

Robotic laparoscopic distal gastrectomy: a comparison of the da Vinci and Zeus systems.

作者信息

Kakeji Y, Konishi K, Ieiri S, Yasunaga T, Nakamoto M, Tanoue K, Baba H, Maehara Y, Hashizume M

机构信息

Department of Surgery and Science, Kyushu University, Higashi-ku, Fukuoka, Japan.

出版信息

Int J Med Robot. 2006 Dec;2(4):299-304. doi: 10.1002/rcs.104.

Abstract

BACKGROUND

The robotic surgical systems working on a master-slave principle have been developed and used in the worldwide in cardiac, urologic, and general surgery.

METHODS

The two robotic systems, the da Vinci and the Zeus Robotic Surgical System (Intuitive Surgical, Calif., USA), were compared with the aim of evaluating operative feasibility and technical efficacy in distal gastrectomy.

RESULTS

During laparoscopic gastrectomy, the da Vinci System (n = 2) had a shorter total operative time (445 versus 656 minutes; p = 0.09) and less blood loss (65 versus 277 mL; p = 0.08) compared with the Zeus System (n = 3). The articulated instruments of both systems were useful in lymph node dissection, isolation of vessels in fat tissue, ligation of vessels, and intraabdominal anastomosis of the gastrointestinal tract. Robotic laparoscopic procedures can be performed effectively using either the da Vinci or Zeus System.

CONCLUSION

In this limited study, the robotic instruments, especially those of da Vinci system, made it easier to complete tissue dissection including lymph nodes, complicated endoscopic anastomoses, and ligatures in a closed cavity.

摘要

背景

基于主从原理工作的机器人手术系统已在全球范围内开发并应用于心脏、泌尿外科和普通外科手术。

方法

比较了两种机器人系统,即达芬奇机器人手术系统和宙斯机器人手术系统(美国加利福尼亚州直观外科公司),目的是评估远端胃切除术的手术可行性和技术疗效。

结果

在腹腔镜胃切除术中,与宙斯系统(n = 3)相比,达芬奇系统(n = 2)的总手术时间更短(445分钟对656分钟;p = 0.09),失血量更少(65毫升对277毫升;p = 0.08)。两种系统的关节式器械在淋巴结清扫、脂肪组织中血管的分离、血管结扎以及胃肠道的腹腔内吻合方面均很有用。使用达芬奇或宙斯系统均可有效进行机器人腹腔镜手术。

结论

在这项有限的研究中,机器人器械,尤其是达芬奇系统的器械,使得在封闭腔内更容易完成包括淋巴结在内的组织解剖、复杂的内镜吻合和结扎。

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