Division of Gynecologic Oncology, Mitchell Cancer Institute, University of South Alabama, 1660 Springhill Avenue, Mobile, AL 36604-1405, USA.
Surg Endosc. 2010 Jun;24(6):1256-60. doi: 10.1007/s00464-009-0756-0. Epub 2009 Dec 24.
The majority of data published on robotic surgery in gynecologic oncology has focused on patient outcomes and surgical data. We have found that technical challenges due to the complexity of the robotic technology create a separate set of issues, adding time and difficulty to the actual surgical procedure. This study focuses on these technical problems and identifies pitfalls and potential solutions in robotics.
All patients who underwent robotic surgery for gynecologic oncology indications from August 2006 through July 2008 were eligible for inclusion in the study. Data collected prospectively included demographics, surgical and clinicopathologic data, and technical problems with the robotic equipment.
One hundred thirty-seven patients underwent robotic surgery during the study period. A total of 11 cases (8.02%) were associated with problems with robotic technology: 2/11 (18.2%) involved malfunction of robotic arms, 2/11 (18.2%) involved light or camera cords, and the remainder included a variety of problems, including malfunction of Maylard bipolar instrument [1/11 (9.1%)], power failure requiring reboot of robot [1/11 (9.1%)], port problems [2/11 (18.2%)], and 3/1 (27.3%) had miscellaneous problems. An estimated average of 25 min was added to each of these 11 cases in order to solve robot-related technological problems. No cases required conversion to laparotomy. All problems were solved by the robotic surgeon with the assistance of robotic surgery staff.
Surgeons performing robotic surgery must become familiar with troubleshooting robotic technology. Several issues related to technical problems may arise, delaying progression of the case, and potential solutions were identified. As this technology is implemented, robotic surgeons must be trained to solve problems related to the robotic technology and associated equipment. Failure to do so may add time and technical difficulty to robotic cases.
大多数发表的关于妇科肿瘤机器人手术的数据都集中在患者的结果和手术数据上。我们发现，由于机器人技术的复杂性而导致的技术挑战会产生另一套问题，给实际手术过程增加了时间和难度。本研究专注于这些技术问题，并确定了机器人技术中的陷阱和潜在解决方案。
所有 2006 年 8 月至 2008 年 7 月期间因妇科肿瘤适应证而行机器人手术的患者均符合本研究纳入标准。前瞻性收集的数据包括人口统计学资料、手术和临床病理数据以及机器人设备的技术问题。
研究期间共 137 例患者接受了机器人手术。共有 11 例（8.02%）与机器人技术问题相关：2/11（18.2%）涉及机器人臂故障，2/11（18.2%）涉及光或摄像头线，其余包括各种问题，包括 Maylard 双极仪器故障[1/11（9.1%）]、需要重新启动机器人的电源故障[1/11（9.1%）]、端口问题[2/11（18.2%）]，3/1（27.3%）有其他杂项问题。为了解决与机器人相关的技术问题，这些病例平均每个增加了约 25 分钟。没有病例需要转为剖腹手术。所有问题均由机器人外科医生在机器人手术人员的协助下解决。
行机器人手术的外科医生必须熟悉故障排除机器人技术。可能会出现与技术问题相关的几个问题，延迟手术进程，并确定了潜在的解决方案。随着这项技术的实施，机器人外科医生必须接受培训，以解决与机器人技术和相关设备相关的问题。如果不这样做，可能会给机器人手术增加时间和技术难度。
