Nakamura Hiroshige, Taniguchi Yuji
Division of General Thoracic Surgery, Tottori University, Yonago, Japan.
Kyobu Geka. 2014 Jul;67(8):741-6.
The most favorable advantage of robotic surgery is the markedly free movement of joint-equipped robotic forceps under 3-dimensional high-vision. Accurate operation makes complex procedures straightforward and may overcome weak points of previous thoracoscopic surgery. The efficiency and safety improves with acquiring skills. However, the spread of robotic surgery in the general thoracic surgery field has been delayed compared to those in other fields. The surgical indications include primary lung cancer, thymic diseases, and mediastinal tumors, but it is unclear whether technical advantages felt by operators are directly connected to merits for patients. Moreover, problems concerning the cost and education have not been solved. Although evidence is insufficient for robotic thoracic surgery, it may be an extension of thoracoscopic surgery, and reports showing its usefulness for primary lung cancer, myasthenia gravis, and thymoma have been accumulating. Now, important thing is to carry out clinical trial for advanced medical care and insurance acquisition. Although it is necessary to solve important problems such as safety, education, training, the cost for the future development, advancing robot technology has a possibility to markedly change general thoracic surgery.
机器人手术最有利的优势在于,配备有关节的机器人钳在三维高清视野下具有明显的自由活动能力。精确的操作使复杂手术变得简单直接,并且可能克服以往胸腔镜手术的不足之处。随着技能的掌握,手术效率和安全性会提高。然而,与其他领域相比,机器人手术在普通胸外科领域的推广一直滞后。手术适应症包括原发性肺癌、胸腺疾病和纵隔肿瘤,但术者所感受到的技术优势是否直接等同于对患者的益处尚不清楚。此外,成本和培训问题尚未得到解决。尽管机器人胸外科手术的证据尚不充分,但它可能是胸腔镜手术的延伸,并且显示其对原发性肺癌、重症肌无力和胸腺瘤有用的报告一直在积累。现在,重要的是开展临床试验以获得先进医疗护理和医保覆盖。尽管有必要解决诸如安全性、培训、未来发展成本等重要问题,但先进的机器人技术有可能显著改变普通胸外科手术。