Medina Melissa G, Tsoraides Steven S, Dwyer Anthony M
University of Illinois College of Medicine at Peoria, Office of Graduate Medical Education, Peoria, IL, USA.
Department of General Surgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
Updates Surg. 2018 Sep;70(3):369-374. doi: 10.1007/s13304-018-0580-y. Epub 2018 Aug 17.
As the field of surgery advances, new approaches have allowed surgeons additional flexibility to perform further interventions with minimal or no external incisions. For many years, single site access (SSA) has been used for transanal procedures, and platforms allowing modified endoscopic approaches have been available. These platforms have limitations related to access, visualization, dexterity, camera control, and instrumentation. Recently, surgical robotics companies have developed and introduced new technologies and platforms, which may help address some of these limitations. Comprehensive internet, open access, and medical and industry conference reviews of robotic surgery platforms and technology available for use in SSA surgery were conducted and 30 articles were found using keywords "robotic surgery, transanal, single site, robotic transanal surgery". A PubMed, Medline, Journals @OVID and open access search for data related to these platforms and technologies was also performed yielding 11 articles. Abstracts were reviewed for those written in the English language, leaving 40 articles which were then filtered for those pertaining to robotic surgery, transanal. 58 abstracts were found, duplicates were eliminated, and the remaining 35 articles were read in their entirety by two reviewers. Several new and existing platforms are identified for use in SSA surgery for transanal surgery as well as abdominal and transoral surgery. These are reviewed, including brand, features, approved and suggested uses, and potential limitations. New robotic technologies serve to enhance the ability of surgeons to perform SSA surgery. This next generation of robotic surgery technology overcomes some of the limitations of preceding endoscopic SSA surgery technology and will enhance the advancement of robotic transanal surgery, but outcomes and performance data are still limited.
随着外科领域的不断发展，新的手术方法使外科医生能够更灵活地进行进一步干预，且只需进行最小限度的外部切口或无需外部切口。多年来，单孔入路（SSA）已用于经肛门手术，并且已有允许改良内镜手术方法的平台。这些平台在入路、可视化、灵活性、摄像头控制和器械使用方面存在局限性。最近，手术机器人公司开发并推出了新技术和平台，这可能有助于解决其中一些局限性。我们对可用于SSA手术的机器人手术平台和技术进行了全面的互联网搜索、开放获取搜索以及医学和行业会议综述，使用关键词“机器人手术、经肛门、单孔、机器人经肛门手术”共找到30篇文章。我们还在PubMed、Medline、OVID期刊和开放获取数据库中搜索了与这些平台和技术相关的数据，得到11篇文章。对英文撰写的摘要进行了审查，筛选出40篇文章，然后进一步筛选出与机器人经肛门手术相关的文章。共找到58篇摘要，去除重复项后，由两名审阅者完整阅读了其余35篇文章。我们确定了几个新的和现有的平台可用于经肛门手术以及腹部和经口手术的SSA手术。对这些平台进行了综述，包括品牌、特点、批准和建议的用途以及潜在局限性。新的机器人技术有助于提高外科医生进行SSA手术的能力。这一代新一代机器人手术技术克服了先前内镜SSA手术技术的一些局限性，将推动机器人经肛门手术的发展，但结果和性能数据仍然有限。
