The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Marburg 118, Baltimore, Maryland 21287, USA.
Nat Rev Urol. 2017 Dec;14(12):731-741. doi: 10.1038/nrurol.2017.149. Epub 2017 Sep 12.
Robot assistance has been rapidly adopted by urological surgeons and has become particularly popular for oncological procedures involving the retroperitoneal space. The wide dissemination of robot assistance probably reflects the limited amount of operating space available within the retroperitoneum and the advantages provided by robot-assisted approaches, including 3D imaging, wristed instrumentation and the shorter learning curve compared with that associated with the equivalent laparoscopic techniques. Surgical procedures that have traditionally been performed using an open or laparoscopic approach, such as partial nephrectomy, radical nephrectomy, retroperitoneal lymph node dissection, nephroureterectomy and adrenalectomy, are now often being performed using robot assistance. The frontiers of robot-assisted retroperitoneal oncological surgery are constantly expanding, with an emphasis on maintaining oncological and functional outcomes, while minimizing the level of surgical invasiveness.
机器人辅助技术已被泌尿外科医师迅速采用,并在涉及腹膜后腔的肿瘤学手术中变得特别流行。机器人辅助技术的广泛传播可能反映了腹膜后腔中可用的操作空间有限,以及机器人辅助方法提供的优势,包括 3D 成像、腕式器械以及与等效腹腔镜技术相比更短的学习曲线。传统上采用开放或腹腔镜方法进行的手术,如部分肾切除术、根治性肾切除术、腹膜后淋巴结清扫术、肾输尿管切除术和肾上腺切除术,现在通常采用机器人辅助技术进行。机器人辅助腹膜后肿瘤学手术的前沿正在不断扩展,重点是保持肿瘤学和功能结果,同时最大限度地减少手术的侵袭性。