Ricciardi Sara, Cardillo Giuseppe, Zirafa Carmelina Cristina, Davini Federico, Melfi Franca
Division of Thoracic Surgery, University Hospital of Pisa, Pisa, Italy.
Unit of Thoracic Surgery, San Camillo-Forlanini Hospital, Rome, Italy.
J Vis Surg. 2017 Aug 21;3:112. doi: 10.21037/jovs.2017.07.09. eCollection 2017.
During the last decade, an abundance of papers has supported minimally invasive pulmonary resections (MIPR) vs. traditional open approach. Both video assisted thoracic surgery (VATS) and robotic thoracic surgery have shown better perioperative outcomes and equivalent oncologic results compared with thoracotomy, confirming the effectiveness of the MIPR. Despite the profound changes and improvements that have taken place throughout the years and the increasing use of robotic system worldwide, the controversy about the application of robotic surgery for lung resections is still open. Some authors wonder about the advantages of using a more expensive and more complex platform for thoracic surgery instead of the more established VATS technique. Robotic thoracic surgery represents, although the cumulative experience worldwide is still limited and evolving, a significant evolution over VATS, nonetheless several authors criticize the longer operative time and the high costs of robotic procedures. The aim of this paper is to answer two relevant questions: why and when the application of robotic technology in thoracic surgery is appropriate?
在过去十年中，大量论文支持微创肺切除术（MIPR）优于传统开放手术方式。与开胸手术相比，电视辅助胸腔镜手术（VATS）和机器人辅助胸腔手术均显示出更好的围手术期结果以及相当的肿瘤学效果，证实了MIPR的有效性。尽管多年来发生了深刻的变化和改进，并且机器人系统在全球范围内的使用越来越多，但关于机器人手术在肺切除术中应用的争议仍然存在。一些作者质疑，相较于更成熟的VATS技术，使用更昂贵、更复杂的平台进行胸外科手术有何优势。尽管全球范围内的累积经验仍然有限且在不断发展，但机器人辅助胸腔手术相较于VATS仍是一项重大进展，尽管如此，仍有几位作者批评机器人手术操作时间较长且成本高昂。本文旨在回答两个相关问题：为什么以及何时在胸外科手术中应用机器人技术是合适的？
