机器人手术的现状。
Current status of robotic surgery.
作者信息
Giri Subhasis, Sarkar Diptendra K
机构信息
Department of Urology, University College Hospital London, London, UK.
出版信息
Indian J Surg. 2012 Jun;74(3):242-7. doi: 10.1007/s12262-012-0595-4. Epub 2012 Jul 5.
Surgery has increasingly become a technology-driven specialty. Robotic assistance is considered one innovation within abdominal surgery over the past decade that has the potential to compensate for the drawbacks of conventional laparoscopy. The dramatic evolution of robotic surgery over the past 10 years is likely to be eclipsed by even greater advances over the next decade. We review the current status of robotic technology in surgery. The Medline database was searched for the terms "robotic surgery, telesurgery, and laparoscopy." A total of 2,496 references were found. All references were considered for information on robotic surgery in advanced laparoscopy. Further references were obtained through cross-referencing the bibliography cited in each work. There is a paucity of control studies on a sufficient number of subjects in robot-assisted surgeries in all fields. Studies that meet more stringent clinical trials criteria show that robot-assisted surgery appears comparable to traditional surgery in terms of feasibility and outcomes but that costs associated with robot-assisted surgery are higher because of longer operating times and expense of equipment. While a limited number of studies on the da Vinci robotic system have proven the benefit of this approach in regard to patient outcomes, including significantly reduced blood loss, lower percentage of postoperative complications, and shorter hospital stays, there are mechanical and institutional risks that must be more fully addressed. Robotic assistance will remain an intensively discussed subject since clinical benefits for most procedures have not yet been proven. While the benefit still remains open to discussion, robotic systems are spreading and are available worldwide in tertiary centers.
外科手术日益成为一个由技术驱动的专业领域。机器人辅助被认为是过去十年腹部手术中的一项创新,它有可能弥补传统腹腔镜手术的缺点。在过去10年里,机器人手术的巨大发展很可能会被未来十年更大的进步所超越。我们回顾了机器人技术在外科手术中的现状。在Medline数据库中搜索了“机器人手术、远程手术和腹腔镜检查”等术语。共找到2496篇参考文献。所有参考文献都被考虑用于获取有关高级腹腔镜手术中机器人手术的信息。通过交叉引用每篇文献中引用的参考文献,又获得了更多的参考文献。在所有领域的机器人辅助手术中,针对足够数量受试者的对照研究很少。符合更严格临床试验标准的研究表明,机器人辅助手术在可行性和手术结果方面似乎与传统手术相当,但由于手术时间更长和设备费用高昂,机器人辅助手术的成本更高。虽然对达芬奇机器人系统的有限数量研究已经证明了这种方法在患者手术结果方面的益处,包括显著减少失血、降低术后并发症发生率和缩短住院时间,但仍存在一些机械和机构风险,必须更全面地加以解决。由于大多数手术的临床益处尚未得到证实,机器人辅助仍将是一个备受热议的话题。虽然其益处仍有待讨论,但机器人系统正在普及,并在全球范围内的三级医疗中心都可使用。
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