Nota Carolijn L, Rinkes Inne H Borel, Hagendoorn Jeroen
Department of Surgical Specialties, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Hepatobiliary Surg Nutr. 2017 Aug;6(4):239-245. doi: 10.21037/hbsn.2016.12.05.
Currently the majority of liver resections are performed via open resection. Nevertheless, minimally invasive liver surgery is gaining ground and conventional laparoscopy has proven to be beneficial in different fields of liver surgery compared to open resections. Still, conventional laparoscopy has a few downsides, from which straight instruments, 2-dimensional view and awkward ergonomics are the most obvious. The robotic surgical system is developed to overcome these limitations. It offers several advantages over conventional laparoscopy to optimize conditions in minimally invasive surgery: instruments are wristed with a wide range of motion and the view is 3-dimensional and magnified. With instruments with a greater range of motion than in laparoscopic surgery, the use of a robotic system potentially broadens indications for minimally invasive liver resection. Here, we discuss the steps of setting up a robotic hepatectomy program against the background of the initial experience at our institution.
目前，大多数肝脏切除术是通过开放手术进行的。然而，微创肝脏手术正在逐渐普及，与开放手术相比，传统腹腔镜手术已被证明在肝脏手术的不同领域中具有优势。尽管如此，传统腹腔镜手术仍存在一些缺点，其中最明显的是器械直、二维视野以及操作不便。机器人手术系统的开发旨在克服这些局限性。与传统腹腔镜手术相比，它具有几个优势，可优化微创手术的条件：器械具有腕关节，活动范围广，视野为三维且放大。由于器械的活动范围比腹腔镜手术更大，使用机器人系统可能会扩大微创肝切除术的适应症。在此，我们结合本机构的初步经验，讨论建立机器人肝切除术方案的步骤。
