Rassweiler J J, Goezen A S, Rassweiler-Seyfried M C, Liatsikos E, Bach T, Stolzenburg J-U, Klein J
Klinik für Urologie und Kinderurologie, SLK Kliniken Heilbronn, Akademisches Lehrkrankenhaus der Universität Heidelberg, Am Gesundbrunnen 20, 74074, Heilbronn, Deutschland.
Urologische Klinik, Univeristätsklinikum Mannheim, Mannheim, Deutschland.
Urologe A. 2018 Sep;57(9):1075-1090. doi: 10.1007/s00120-018-0733-0.
The monopoly of robotic surgical devices of the last 15 years will end in 2019 when key patents of Intuitive Surgical expire. Thus, we can expect an interesting competitive situation in the coming years. Based on personal experience with robot-assisted surgery since 2001, we conducted a search of the current literature together with a search of relevant patents in this field. Finally, we visited the websites of manufacturers of existing and future robotic surgical devices with possible applications in urology. Such devices have to prove that they meet the high-quality standard of the current Da Vinci series (SI, X, XI). For this purpose, we propose to classify the main features of the different devices, such as type of console (closed/open), arrangement of robotic arms (single/multiple carts/attached to operating room table), type of three-dimensional videosystem (by mirror/ocular/using polarizing glasses) or degrees of freedom (DOF) of end effectors (5 vs. 7 DOF). In the meantime, there are also robotic systems used in endourology: Avicenna Roboflex® and the AquaBeam® system for robot-assisted aquablation therapy of the prostate. While Roboflex® improves the ergonomics of flexible ureteroscopy-similar to the Da Vinci robot, AquaBeam® may for the first time eliminate the surgeon, who might only be needed to manage severe postoperative bleeding.
过去15年里,直观外科手术公司(Intuitive Surgical)的机器人手术设备一直处于垄断地位,这种情况将于2019年随着该公司关键专利的到期而结束。因此,我们预计未来几年会出现有趣的竞争局面。基于自2001年以来在机器人辅助手术方面的个人经验,我们检索了当前文献,并在该领域检索了相关专利。最后,我们访问了现有及未来可能应用于泌尿外科的机器人手术设备制造商的网站。这类设备必须证明它们符合当前达芬奇系列(SI、X、XI)的高质量标准。为此,我们建议对不同设备的主要特征进行分类,比如控制台类型(封闭/开放)、机械臂布局(单台车/多台车/附于手术台)、三维视频系统类型(通过镜子/目镜/使用偏光眼镜)或末端执行器的自由度(DOF)(5自由度与7自由度)。与此同时,腔内泌尿外科也在使用机器人系统:用于前列腺机器人辅助水刀消融治疗的阿维森纳Roboflex®和AquaBeam®系统。与达芬奇机器人类似,Roboflex®改善了软性输尿管镜检查的人体工程学,而AquaBeam®可能首次无需外科医生参与,外科医生可能仅在处理严重术后出血时才会被需要。