Tzvetanov Ivo, Bejarano-Pineda Lorena, Giulianotti Pier C, Jeon Hoonbae, Garcia-Roca Raquel, Bianco Francesco, Oberholzer José, Benedetti Enrico
Division of Transplantation, Department of Surgery, University of Illinois Hospital & Health Sciences System, 840 South Wood Street, CSB 402, MC 958, Chicago, IL, 60612, USA,
World J Surg. 2013 Dec;37(12):2791-9. doi: 10.1007/s00268-013-2244-x.
Within the last two decades the application of minimally invasive surgical technologies has shown significant benefits when it comes to complex surgical procedures. Lower rates of complications and higher patient satisfaction are commonly reported. Until recently these benefits were inaccessible for patients with solid organ transplantation, because conventional laparoscopy was seen as nonapplicable in such technically demanding procedures. The introduction of the da Vinci Robotic Surgical System, with its inherent advantages, has expanded the ability to complete solid organ transplantation in a minimally invasive fashion. Robotic applications in kidney, pancreas, and liver transplantation have been reported. The initial results showed the viability of this technique in the field. The most extensive experience has been described in kidney transplantation. Over 700 donor nephrectomies and more than 70 renal transplants have been performed successfully with the robotic system. The proven advantage of the robotic technique, especially in obese kidney recipients, is a significantly lower rate of surgical site infection, which in these highly immunosuppressed patients is reflected in superior outcomes. The first results in pancreas transplantation and living donor hepatectomy are very promising; however, larger series are needed in order to address the value of the robotic surgery in these areas of solid organ transplantation.
在过去二十年中，微创外科技术在复杂手术过程中展现出显著优势。常见报道称并发症发生率更低且患者满意度更高。直到最近，实体器官移植患者仍无法享受到这些益处，因为传统腹腔镜手术被认为不适用于此类技术要求高的手术。达芬奇机器人手术系统的引入及其固有优势，扩展了以微创方式完成实体器官移植的能力。已有关于机器人技术在肾、胰腺和肝移植中的应用报道。初步结果表明了该技术在该领域的可行性。肾移植方面的经验最为丰富。使用机器人系统已成功进行了700多例供肾切除术和70多例肾移植手术。机器人技术已证实的优势，尤其是在肥胖肾移植受者中，是手术部位感染率显著降低，这在这些高度免疫抑制的患者中体现为更好的治疗效果。胰腺移植和活体供肝切除术的初步结果非常有前景；然而，需要更大规模的系列研究来探讨机器人手术在这些实体器官移植领域的价值。
