Sinha Rooma, Sanjay Madhumati, Rupa B, Kumari Samita
Department of Obstetrics and Gynecology, Apollo Health City, Hyderabad, Telangana, India.
J Minim Access Surg. 2015 Jan-Mar;11(1):50-9. doi: 10.4103/0972-9941.147690.
FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.
2005年，美国食品药品监督管理局（FDA）批准了达芬奇手术系统用于妇科手术。该系统已被迅速采用，并在各可用中心占据了重要地位。它由三个部分组成：外科医生控制台、带有四个机械臂的患者侧推车以及高清三维（3D）视觉系统。在本综述中，我们讨论了各种机器人辅助腹腔镜良性妇科手术，如子宫肌瘤切除术、子宫切除术、子宫内膜异位症、输卵管吻合术和骶骨阴道固定术。我们进行了PubMed搜索并回顾了相关的已发表研究。还提到了可能有未来应用的手术。目前，大多数研究表明，在良性妇科疾病中，与传统腹腔镜手术相比，机器人手术并没有显著优势。然而，在更复杂的手术中，机器人手术确实具有优势。与腹腔镜手术相比，机器人辅助下转为开放手术的比率更低。对于子宫肌瘤切除术，机器人器械的腕部运动比传统的直杆腹腔镜手术能实现更好、更精确的缝合。机器人平台是腹腔镜手术的合理发展方向，如果成本问题得到解决，可能会在全球妇科外科医生中受到欢迎。
