Warren Jeff, da Silva Vitor, Caumartin Yves, Luke Patrick P W
Department of Surgery, Division of Urology, University of Western Ontario.
Can Urol Assoc J. 2009 Jun;3(3):231-240. doi: 10.5489/cuaj.1080.
The development, advancement and clinical integration of robotic technology in surgery continue at a staggering pace. In no other discipline has this rapid evolution occurred to a greater degree than in urology. Although radical prostatectomy has grown to become the prototypical application for the robot, the role of the robot in renal surgery remains controversial. Herein we review the literature on robotic renal surgery. A comprehensive PubMed literature search was performed to identify all published reports relating to robotic renal surgery. All clinically related articles involving human participants were critically appraised in this review. Fifty-one clinical articles were included, encompassing robot-assisted pyeloplasty, nephrectomy, nephroureterectomy, living-donor nephrectomy and partial nephrectomy. Feasibility has been shown for each of these procedures. Robot-assisted techniques have been described for almost all renal-related procedures. However, the intersect between feasibility and necessity as it pertains to robotic renal surgery has yet to be defined. Also, the high cost of surgical robotic technology mandates critical appraisal before adoption, especially in a publicly funded health care system, such as the one present in Canada.
机器人技术在外科手术中的发展、进步及临床整合正以惊人的速度持续推进。在泌尿外科领域,这种快速发展的程度比其他任何学科都更为显著。尽管根治性前列腺切除术已逐渐成为机器人的典型应用,但机器人在肾脏手术中的作用仍存在争议。在此,我们回顾了有关机器人肾脏手术的文献。通过全面检索PubMed文献,以识别所有已发表的与机器人肾脏手术相关的报告。本综述对所有涉及人类受试者的临床相关文章进行了严格评估。纳入了51篇临床文章,涵盖机器人辅助肾盂成形术、肾切除术、肾输尿管切除术、活体供肾切除术和部分肾切除术。这些手术均已证明具有可行性。几乎所有与肾脏相关的手术都有机器人辅助技术的描述。然而,与机器人肾脏手术相关的可行性和必要性之间的交叉点尚未明确。此外,手术机器人技术的高昂成本要求在采用之前进行严格评估,尤其是在像加拿大这样的公共资助医疗保健系统中。