Waseda Ryuichi, Ishikawa Norihiko, Oda Makoto, Matsumoto Isao, Ohta Yasuhiko, Inaki Noriyuki, Hirano Yasumitsu, Watanabe Go
Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
J Thorac Cardiovasc Surg. 2007 Oct;134(4):989-95. doi: 10.1016/j.jtcvs.2007.07.002.
Robotic telemanipulation systems have been introduced recently to enhance the surgeon's dexterity and visualization in endoscopic surgery and thus facilitate refined dissection, suturing, and knot tying. This study examined the technical feasibility of performing safe and efficient robot-assisted, hand-sewn endoscopic airway reconstruction in a rabbit model.
A total of 18 tracheal anastomoses were performed in rabbits, with 6 anastomoses performed endoscopically using the da Vinci Surgical system (Robot group), 6 anastomoses performed using traditional thoracoscopic surgical instruments (VATS group), and 6 anastomoses performed using open surgical instruments (Open group). Anastomosis time and complications were recorded. The effectiveness of anastomoses was evaluated by postoperative observation of all rabbits for 8 weeks and measurement of anastomotic stricture and pathologic findings. These parameters and anastomosis time were compared between groups.
In all cases in the Robot group, the procedure was completed endoscopically. No perioperative or postoperative complications were encountered. Mean procedure time of the Robot group was 14.1 +/- 2.6 minutes (mean +/- standard deviation). Anastomosis time in the Robot group was significantly shorter than in the VATS group (33.5 +/- 5.2 minutes, P = .0039) and was not significantly different in the Open group (11.4 +/- 2.3 minutes, P = .1282). All anastomoses in the Robot group remained mechanically intact, and all parameters were comparable with those of the open surgery group.
The technical feasibility of performing safe and efficient robot-assisted endoscopic airway reconstruction was repeatedly demonstrated in a rabbit model. Robotic assistance significantly improved the time associated with and the quality of endoscopic airway reconstruction.
机器人远程操作手术系统最近已被引入，以提高外科医生在内镜手术中的灵活性和可视化程度，从而便于精细的解剖、缝合和打结操作。本研究探讨了在兔模型中进行安全、高效的机器人辅助手工缝合内镜气道重建的技术可行性。
对兔进行了总共18次气管吻合术，其中6次使用达芬奇手术系统在内镜下进行吻合（机器人组），6次使用传统胸腔镜手术器械进行吻合（电视辅助胸腔镜手术组），6次使用开放手术器械进行吻合（开放组）。记录吻合时间和并发症情况。通过对所有兔子进行8周的术后观察以及测量吻合口狭窄和病理结果来评估吻合的有效性。比较各组之间的这些参数和吻合时间。
在机器人组的所有病例中，手术均在内镜下完成。未遇到围手术期或术后并发症。机器人组的平均手术时间为14.1±2.6分钟（平均值±标准差）。机器人组的吻合时间明显短于电视辅助胸腔镜手术组（33.5±5.2分钟，P = 0.0039），与开放组相比无显著差异（11.4±2.3分钟，P = 0.1282）。机器人组的所有吻合口在机械上均保持完整，所有参数与开放手术组相当。
在兔模型中反复证明了进行安全、高效的机器人辅助内镜气道重建的技术可行性。机器人辅助显著改善了内镜气道重建的时间和质量。
Zotero 插件