Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.
Curr Opin Urol. 2010 Mar;20(2):119-24. doi: 10.1097/MOU.0b013e3283362563.
Robot-assisted partial nephrectomy (RAPN) is emerging as a viable complement to traditional laparoscopic and open partial nephrectomy. As a relatively new technique, the techniques and technologies employed during RAPN continue to evolve. In the present article, we provide an overview of the evolution of robot-assisted renal surgery, and highlight the recent advances that have helped to bring RAPN to the fore.
The learning curve for RAPN appears to be slight, and technical proficiency may be quickly achieved, even for those with limited laparoscopic experience. Recent advances include improvements in ergonomics of the robotic system itself, as well as the introduction of sliding-clip renorrhaphy, early unclamping techniques, and off-clamp techniques. Early-to-intermediate outcomes are very promising, demonstrating short warm ischemic times, and a low rate of complication and recurrence. Disadvantages to the approach include substantial cost, as well as increased reliance upon the assistant to perform critical maneuvers.
Robot-assisted partial nephrectomy appears to be a safe and efficacious technique for the surgical management of localized renal malignancy. Recent developments have focused upon reducing ischemic insult, as well as decreasing reliance upon the assistant.
机器人辅助部分肾切除术（RAPN）作为传统腹腔镜和开放部分肾切除术的一种可行补充方法，正在兴起。作为一种相对较新的技术，RAPN 所采用的技术和技术仍在不断发展。本文概述了机器人辅助肾脏手术的发展，并强调了有助于将 RAPN 推向前沿的最新进展。
RAPN 的学习曲线似乎很轻微，即使对于那些腹腔镜经验有限的人来说，技术熟练程度也可以很快达到。最近的进展包括改进机器人系统本身的人体工程学，以及引入滑动夹肾缝合、早期松开技术和无夹技术。早期至中期的结果非常有希望，表明热缺血时间短，并发症和复发率低。该方法的缺点包括成本高，以及对助手执行关键操作的依赖增加。
机器人辅助部分肾切除术似乎是治疗局限性肾恶性肿瘤的一种安全有效的手术方法。最近的发展重点是减少缺血损伤，以及减少对助手的依赖。
