Cantrell Leigh A, Oberholzer José
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia.
Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
Curr Opin Organ Transplant. 2018 Aug;23(4):423-427. doi: 10.1097/MOT.0000000000000555.
Robotic pancreas transplantation is a novel procedure that aims to reduce surgical invasiveness, and thereby limit complications related to the surgical access. Given that few centers are providing robotic transplantation, this review serves as a state of the science article to outline early experiences and highlight areas for future research.
Pancreas transplantation results in relatively high rates of wound and other surgical complications that are known to deleteriously impact outcomes. The minimally invasive, robotic-assisted approach decreases wound complications. Because of the obesity epidemic, overweight and obese status is encountered in an increasing number of transplant candidates. These candidates are subject to increased wound-related complications and most benefit from a robotic approach. The first clinical reports on laparoscopic, robotic-assisted kidney and pancreas transplantation indicate a significant decrease in wound complications and excellent outcomes in obese patients otherwise denied access to transplantation.
With excellent results achieved in surgically challenging patients and further accumulation of experience, laparoscopic, robotic-assisted pancreas and kidney transplantation may evolve to a new standard approach.
机器人胰腺移植是一种旨在降低手术侵袭性从而减少与手术入路相关并发症的新型手术。鉴于仅有少数中心开展机器人移植手术，本综述作为一篇科学现状文章，旨在概述早期经验并突出未来研究方向。
胰腺移植会导致相对较高的伤口及其他手术并发症发生率，而这些并发症已知会对手术结果产生不利影响。微创机器人辅助手术方法可减少伤口并发症。由于肥胖症流行，越来越多的移植候选者存在超重和肥胖问题。这些候选者更容易出现与伤口相关的并发症，并且大多能从机器人手术方法中获益。关于腹腔镜机器人辅助肾和胰腺移植的首批临床报告表明，伤口并发症显著减少，肥胖患者取得了良好的手术效果，否则这些患者可能无法接受移植手术。
鉴于在手术难度较大的患者中取得了良好效果，且经验进一步积累，腹腔镜机器人辅助胰腺和肾移植可能会发展成为一种新的标准手术方法。
