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机器人手术——谁才是主导？

Robotic Surgery - Who is The Boss?

作者信息

Schuler Patrick J

机构信息

Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm.

出版信息

Laryngorhinootologie. 2018 Mar;97(S 01):S231-S278. doi: 10.1055/s-0043-121791. Epub 2018 Mar 22.

DOI:10.1055/s-0043-121791
PMID:29905359
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6541110/
Abstract

In the head and neck region, great potential is seen in robot-assisted surgery (RAS). Mainly in cancer surgery, the use of robotic systems seems to be of interest. Until today, two robotic systems (DaVinci® und FLEX®) have gained approval for clinical use in the head and neck region, and multiple other systems are currently in pre-clinical testing. Although, certain groups of patients may benefit from RAS, no unbiased randomized clinical studies are available. Until today, it was not possible to satisfactorily prove any advantage of RAS as compared to standard procedures. The limited clinical benefit and the additional financial burden seem to be the main reasons, why the comprehensive application of RAS has not been realized so far.This review article describes the large variety of clinical applications for RAS in the head and neck region. In addition, the financial and technical challenges, as well as ongoing developments of RAS are highlighted. Special focus is put on risks associated with RAS and current clinical studies. We believe, that RAS will find its way into clinical routine during the next years. Therefore, medical staff will have to increasingly face the technical, scientific and ethical features of RAS.

摘要

在头颈部区域，机器人辅助手术（RAS）展现出了巨大的潜力。主要在癌症手术中，机器人系统的应用似乎备受关注。到目前为止，已有两种机器人系统（达芬奇®和FLEX®）获批用于头颈部区域的临床治疗，还有多个其他系统目前正处于临床前测试阶段。尽管某些患者群体可能会从机器人辅助手术中获益，但尚无公正的随机临床研究。到目前为止，与标准手术相比，还无法令人满意地证明机器人辅助手术有任何优势。有限的临床益处和额外的经济负担似乎是迄今为止机器人辅助手术尚未得到广泛应用的主要原因。这篇综述文章描述了机器人辅助手术在头颈部区域的多种临床应用。此外，还强调了其面临的经济和技术挑战，以及机器人辅助手术的持续发展情况。特别关注了与机器人辅助手术相关的风险和当前的临床研究。我们相信，在未来几年里，机器人辅助手术将进入临床常规应用。因此，医务人员将不得不越来越多地面对机器人辅助手术的技术、科学和伦理特点。

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