Children's Hospital of Philadelphia, 34th Street and Civic Center, Boulevard Wood Building 3rd Floor, Philadelphia, PA, 19107, USA.
Seattle Children's Hospital, University of Washington, Seattle, WA, 98105, USA.
J Robot Surg. 2010 Jan;3(4):239-44. doi: 10.1007/s11701-009-0165-3. Epub 2009 Nov 26.
The dictum that "there is nothing new in surgery not previously described," is quoted regularly and is particularly true of hypospadias. There is an ongoing search for solutions to many troublesome issues concerning surgical treatment of hypospadias, such as what age is the most appropriate to apply surgery, or in how many stages surgery should be performed. We present a case report of the first robotic hypospadias surgery to propose a departure from the standard practice, in the hope of expanding medical expertise and teaching globally. The use of a robot for reconstructive surgery is not novel; its use for extracorporeal surgery is, but we contend that there is no difference in the surgical steps to carry out a hypospadias repair. In addition, we envision that the benefits of applying robotic surgery for extracorporeal reconstructive procedures will greatly impact the current paradigm of surgery and surgical education. For those surgeons who already possess comfort with robotic skills, reconstructive procedures outside of a major cavity are feasible, and time will provide safety and efficacy data. Our hope is that others will join in the advancement of telesurgery and its applications and appreciate the potential expansion of surgical knowledge that will be afforded by this change in how we teach and operate.
“外科手术中没有什么是以前没有描述过的”这句格言经常被引用，对于尿道下裂尤其如此。人们一直在寻找解决许多与尿道下裂手术治疗有关的棘手问题的方法，例如何时进行手术最适合，或者手术应该分几个阶段进行。我们报告了首例机器人尿道下裂手术病例，以期背离标准实践，希望能够在全球范围内拓展医学专业知识和教学。机器人用于重建手术并不新鲜；将其用于体外手术是新鲜的，但我们认为，进行尿道下裂修复的手术步骤没有区别。此外，我们设想，将机器人手术应用于体外重建手术将极大地改变当前的手术和手术教育模式。对于那些已经熟练掌握机器人技能的外科医生来说，在非主要腔隙进行重建手术是可行的，时间将提供安全性和有效性数据。我们希望其他人能够加入远程手术的发展及其应用，并认识到通过改变我们的教学和操作方式，将为扩大手术知识提供的潜力。
