Division of Surgery, Department of Surgery and Cancer, ImperialCollege London, UK.
J Vasc Surg. 2011 Feb;53(2):493-9. doi: 10.1016/j.jvs.2010.06.154.
Emerging robotic technologies are increasingly being used by surgical disciplines to facilitate and improve performance of minimally invasive surgery. Robot-assisted intervention has recently been introduced into the field of vascular surgery to potentially enhance laparoscopic vascular and endovascular capabilities. The objective of this study was to review the current status of clinical robotic applications in vascular surgery.
A systematic literature search was performed in order to identify all published clinical studies related to robotic implementation in vascular intervention. Web-based search engines were searched using the keywords "surgical robotics," "robotic surgery," "robotics," "computer assisted surgery," and "vascular surgery" or "endovascular" for articles published between January 1990 and November 2009. An evaluation and critical overview of these studies is reported. In addition, an analysis and discussion of supporting evidence for robotic computer-enhanced telemanipulation systems in relation to their applications in laparoscopic vascular and endovascular surgery was undertaken.
Seventeen articles reporting on clinical applications of robotics in laparoscopic vascular and endovascular surgery were detected. They were either case reports or retrospective patient series and prospective studies reporting laparoscopic vascular and endovascular treatments for patients using robotic technology. Minimal comparative clinical evidence to evaluate the advantages of robot-assisted vascular procedures was identified. Robot-assisted laparoscopic aortic procedures have been reported by several studies with satisfactory results. Furthermore, the use of robotic technology as a sole modality for abdominal aortic aneurysm repair and expansion of its applications to splenic and renal artery aneurysm reconstruction have been described. Robotically steerable endovascular catheter systems have potential advantages over conventional catheterization systems. Promising results from applications in cardiac interventions and preclinical studies have urged their use in vascular surgery. Although successful applications in endovascular repair of abdominal aortic aneurysm and lower extremity arterial disease have been reported, published clinical experience with the endovascular robot is limited.
Robotic technology may enhance vascular surgical techniques given preclinical evidence and early clinical reports. Further clinical studies are required to quantify its advantages over conventional treatments and define its role in vascular and endovascular surgery.
手术学科越来越多地使用新兴的机器人技术来促进和提高微创手术的性能。机器人辅助干预最近已被引入血管外科学领域，以潜在地增强腹腔镜血管和腔内血管的能力。本研究的目的是回顾机器人在血管外科学中的临床应用现状。
进行了系统的文献检索，以确定与血管介入机器人实施相关的所有已发表的临床研究。使用关键字“手术机器人”、“机器人手术”、“机器人”、“计算机辅助手术”和“血管外科学”或“腔内血管学”在网络搜索引擎上进行搜索，检索时间范围为 1990 年 1 月至 2009 年 11 月。对这些研究进行了评估和批判性综述。此外，还对机器人计算机增强远程操纵系统的应用进行了分析和讨论，以评估其在腹腔镜血管和腔内血管外科学中的应用。
共发现 17 篇报道机器人在腹腔镜血管和腔内血管外科学中的临床应用的文章。这些文章为机器人技术治疗患者的腹腔镜血管和腔内血管治疗的病例报告或回顾性患者系列和前瞻性研究。为评估机器人辅助血管手术的优势，确定了最小的临床比较证据。机器人辅助腹腔镜主动脉手术已被几项研究报道，结果令人满意。此外，还描述了机器人技术作为一种单独的方式治疗腹主动脉瘤和扩大其在脾和肾动脉瘤重建中的应用。与传统的导管系统相比，机器人可转向的腔内导管系统具有潜在的优势。在心脏介入和临床前研究中的应用取得了令人鼓舞的结果，促使其在血管外科学中的应用。虽然已经报道了机器人在腹主动脉瘤和下肢动脉疾病的腔内修复中的成功应用，但机器人在腔内血管学中的临床应用经验有限。
鉴于临床前证据和早期临床报告，机器人技术可以增强血管外科学技术。需要进一步的临床研究来量化其相对于传统治疗的优势，并确定其在血管和腔内血管外科学中的作用。
