Department of Otorhinolaryngology-Head and Neck Surgery, Yokohama City University, Yokohama, Japan.
Department of Otolaryngology, Division of Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
Jpn J Clin Oncol. 2019 May 1;49(5):404-411. doi: 10.1093/jjco/hyz020.
Transoral robotic surgery (TORS) utilizing the da Vinci robotic system has opened a new era for minimally-invasive surgery (MIS) in Otolaryngology-Head and Neck Surgery. Awareness of the historical steps in developing robotic surgery (RS) and understanding its current application within our field can help open our imaginations to future of the surgical robotics. We compiled a historical perspective on the evolution of surgical robotics, the road to the da Vinci surgical system, and conducted a review of TORS regarding clinical applications and limitations, prospective clinical trials and current status in Japan. We also provided commentary on the future of surgical robotics within our field. Surgical robotics grew out of the pursuit of telerobotics and the advances in robotics for non-medical applications. Today in our field, cancers and diseases of oropharynx and supraglottis are the most common indications for RS. It has proved capable of preserving the laryngopharyngeal function without compromising oncologic outcomes, and reducing the intensity of adjuvant therapy. TORS has become a standard modality for MIS, and will continue to evolve in the future. As robotic surgical systems evolve with improved capabilities in visual augmentation, spatial navigation, miniaturization, force-feedback and cost-effectiveness, we will see further advances in the current indications, and an expansion of indications. By promoting borderless international collaborations that put 'patients first', the bright future of surgical robotics will synergistically expand to the limits of our imaginations.
经口机器人手术（TORS）利用达芬奇机器人系统为耳鼻喉头颈外科的微创手术（MIS）开辟了新纪元。了解机器人手术（RS）的发展历史步骤，并了解其在我们领域中的当前应用，可以帮助我们开拓对手术机器人未来的想象。我们编写了关于手术机器人发展历程的历史观点、达芬奇手术系统的发展道路，并就 TORS 在临床应用和局限性、前瞻性临床试验以及日本当前状况进行了综述。我们还对我们领域中手术机器人的未来进行了评论。手术机器人源于远程机器人技术的追求和非医疗应用机器人技术的进步。今天，在我们的领域中，口咽和声门上区的癌症和疾病是 RS 的最常见适应症。它已被证明能够在不影响肿瘤学结果的情况下保留喉咽功能，并减少辅助治疗的强度。TORS 已成为 MIS 的标准模式，并且将来还会不断发展。随着机器人手术系统在视觉增强、空间导航、小型化、力反馈和成本效益方面的功能不断改进，我们将在现有适应症方面看到进一步的进展，并扩大适应症范围。通过促进以“患者至上”为宗旨的无边界国际合作，手术机器人的光明未来将协同扩展到我们想象的极限。
