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机器人技术在减重手术中的作用综述:探寻我们的未来?

A Review of the Role of Robotics in Bariatric Surgery: Finding Our Future?

作者信息

Veilleux Eric, Ponce Jaime, Lutfi Rami

机构信息

Advocate Illinois Masonic Medical Center, Chicago, Illinois.

Chattanooga Bariatrics, Chatanooga, Tennessee.

出版信息

J Laparoendosc Adv Surg Tech A. 2020 Jan;30(1):36-39. doi: 10.1089/lap.2019.0419. Epub 2019 Aug 2.

Abstract

Obesity rates continue to rise in America and around the World. Numerous studies show the benefit of bariatric surgery on all-cause mortality in obese patients. Given its substantial role in the future of patient care, we continue to search for the most beneficial ways to optimize patient outcomes and procedural costs in bariatric surgery. Much like laparoscopy was found to greatly improve the morbidity of weight loss surgery, we seek to evaluate the role of robotic surgery in bariatric procedures. We critically reviewed the available literature accessed through PubMed on the use of robotics in bariatric surgery. We aim to provide an overview of the conclusions from the most recent publications with commentary by the authors. Although the outliers exist, it would appear that the majority of cases point to robotic surgery increasing operating room time and cost without providing significant generalizable improvements in patient outcomes. Promise exists in the use for special groups such as super obese patients or revisional bariatric procedures, however current studies in this subset are equally variable in their outcomes. Despite the current assumptions, we believe there is a future in bariatric surgery for robotics. This may inevitably be seen in the more demanding and difficult cases or in the advancement of the available technology. Likely, as robotics continues to mature, applied artificial intelligence will provide enhanced cues during surgery that augment the surgeon's judgment and skill and result in unanimously improved patient outcomes.

摘要

美国乃至全球的肥胖率持续上升。大量研究表明,减肥手术对肥胖患者的全因死亡率有益。鉴于其在未来患者护理中的重要作用,我们继续探索最有益的方法,以优化减肥手术的患者预后和手术成本。就像腹腔镜手术被发现能大大改善减肥手术的发病率一样,我们试图评估机器人手术在减肥手术中的作用。我们严格审查了通过PubMed获取的关于机器人技术在减肥手术中应用的现有文献。我们旨在概述最新出版物的结论,并附上作者的评论。尽管存在异常情况,但大多数案例似乎表明,机器人手术增加了手术室时间和成本,却没有在患者预后方面带来显著的普遍改善。在超肥胖患者或减肥修正手术等特殊群体的应用中存在希望,然而目前该亚组的研究结果同样参差不齐。尽管有当前的种种假设,但我们相信机器人技术在减肥手术中有未来。这可能不可避免地出现在要求更高、难度更大的病例中,或者现有技术的进步中。随着机器人技术不断成熟,应用人工智能可能会在手术过程中提供增强的提示,增强外科医生的判断力和技能,并一致改善患者预后。

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