Service d'ORL et de chirurgie cervico-faciale, faculté de médecine Paris Descartes, Sorbonne Paris Cité, hôpital européen Georges-Pompidou, Assistance publique, 20 rue Leblanc, Paris, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Feb;129(1):32-7. doi: 10.1016/j.anorl.2011.06.003. Epub 2011 Dec 6.
Robots have invaded industry and, more recently, the field of medicine. Following the development of various prototypes, Intuitive Surgical® has developed the Da Vinci surgical robot. This robot, designed for abdominal surgery, has been widely used in urology since 2000. The many advantages of this transoral robotic surgery (TORS) are described in this article. Its disadvantages are essentially its high cost and the absence of tactile feedback. The first feasibility studies in head and neck cancer, conducted in animals, dummies and cadavers, were performed in 2005, followed by the first publications in patients in 2006. The first series including more than 20 patients treated by TORS demonstrated the feasibility for the following sites: oropharynx, supraglottic larynx and hypopharynx. However, these studies did not validate the oncological results of the TORS technique. TORS decreases the number of tracheotomies, and allows more rapid swallowing rehabilitation and a shorter length of hospital stay. Technical improvements are expected. Smaller, more ergonomic, new generation robots, therefore more adapted to the head and neck, will probably be available in the future.
机器人已经入侵了工业领域，最近又进入了医学领域。在开发了各种原型之后，直觉外科公司开发了达芬奇手术机器人。这款机器人最初是为腹部手术设计的，自 2000 年以来已广泛应用于泌尿科。本文介绍了经口机器人手术（TORS）的诸多优点。它的缺点主要是成本高，缺乏触觉反馈。2005 年，在动物、模拟人和尸体上进行了头颈部癌症的首次可行性研究，随后在 2006 年首次在患者身上发表了研究结果。第一个包括 20 多名患者的系列研究证明 TORS 治疗下列部位是可行的：口咽、声门上喉和下咽。然而，这些研究并未证实 TORS 技术的肿瘤学结果。TORS 减少了气管切开术的数量，使吞咽康复更快，住院时间更短。预计会有技术改进。更小、更符合人体工程学、新一代的机器人将更适合头颈部，可能会在未来出现。
