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生殖外科中的机器人辅助腹腔镜检查:当代综述

Robotic-assisted laparoscopy in reproductive surgery: a contemporary review.

作者信息

Jayakumaran Jayapriya, Patel Sejal D, Gangrade Bhushan K, Narasimhulu Deepa Maheswari, Pandian Soundarya Ramanatha, Silva Celso

机构信息

Center for Reproductive Medicine, Orlando, FL, USA.

Maimonides Medical Center, Brooklyn, NY, USA.

出版信息

J Robot Surg. 2017 Jun;11(2):97-109. doi: 10.1007/s11701-017-0682-4. Epub 2017 Feb 14.

Abstract

Robotic surgery is a conceptual fusion of the conventional open surgery and the minimally invasive laparoscopic surgery. We reviewed the current role of robotic-assisted laparoscopy in the field of reproductive surgery by a literature search in PubMed database. We analyzed the reported advantages and limitations of the use of robotics in reproductive surgeries like myomectomy, tubal reanastomosis, endometriosis, ovarian tissue cryopreservation, and ovarian transposition. Overall, robotic assistance in reproductive surgery resulted in decreased blood loss, less post-operative pain, shorter hospital stay, and faster convalescence, whereas reproductive outcomes were similar to open/laparoscopic approaches. The main drawbacks of robotic surgery were higher cost and longer operating times. It is as safe and effective as the conventional laparoscopy and represents a reasonable alternate to abdominal approach. Procedures that are technically challenging with the conventional laparoscopy can be performed with robotic assistance. It has advantages of improved visualization and Endowrist™ movements allowing precise suturing. This helps to overcome the limitations of laparoscopy, especially in complicated procedures, and may shorten the steep learning curve in minimal invasive surgery. Randomized controlled trials looking at both short- and long-term outcomes are warranted to strengthen the role of robotic surgery in the field of reproductive surgery.

摘要

机器人手术是传统开放手术与微创腹腔镜手术的概念融合。我们通过在PubMed数据库中进行文献检索,回顾了机器人辅助腹腔镜手术在生殖外科领域的当前作用。我们分析了在子宫肌瘤切除术、输卵管再吻合术、子宫内膜异位症、卵巢组织冷冻保存和卵巢移位等生殖手术中使用机器人技术的已报道的优点和局限性。总体而言,机器人辅助生殖手术可减少失血、减轻术后疼痛、缩短住院时间并加快康复,而生殖结局与开放/腹腔镜手术方法相似。机器人手术的主要缺点是成本较高和手术时间较长。它与传统腹腔镜手术一样安全有效,是腹部手术方法的合理替代方案。传统腹腔镜手术技术上具有挑战性的手术可以在机器人辅助下进行。它具有改善可视化和Endowrist™运动的优点,允许精确缝合。这有助于克服腹腔镜手术的局限性,特别是在复杂手术中,并且可能缩短微创手术中陡峭的学习曲线。有必要进行观察短期和长期结局的随机对照试验,以加强机器人手术在生殖外科领域的作用。

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