Jiang Yu, Su Zixuan, Liang Hengrui, Liu Jun, Liang Wenhua, He Jianxing
Department of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Nanshan School, Guangzhou Medical University, Guangzhou, China.
J Thorac Dis. 2020 Aug;12(8):4427-4433. doi: 10.21037/jtd-20-1116.
As the computer processing technique and display technology evolved dramatically, the surgical approach to early-stage non-small cell lung cancer (NSCLC) has made a rapid progress within the past few years. Currently, the gold standard for NSCLC is lobectomy. After the introduction of video-assisted thoracoscopic surgery (VATS), lung resection can now be conducted mini-invasively, enabling better prognosis for patients and better operation condition for surgeons. At the very beginning, the conventional two-dimensional (2D) system enabled operators to have a closer, magnified and illuminated view inside the body cavity than open thoracotomy. With the introduction of the glasses-assisted three-dimensional (3D) and glasses-free 3D display system, multiple viewing angles were further enhanced, thus a more stable, easier to master and less invasive video-assisted thoracoscopic surgery (VATS) appeared. However, given that the standard VATS is associated with limited maneuverability and stereoscopy, it restricts the availability in more advanced cases. Hopefully, most of the limitations of standard VATS can be overcome with the robotic-assisted thoracic surgery (RATS). The RATS system consists of a remote console and a robotic unit with 3 or 4 arms that can duplicate surgeons' movements. Also, it provides a magnified, 3D and high definition (HD) operation field to surgeons, allowing them to perform more complicated procedures. Apart from these, some new technologies are also invented in combination with the existing surgery system to solve difficult problems. It is hoped that the higher costs of innovative surgical technique can be offset by the better patient outcomes and improved benefits in cost-effectiveness.
随着计算机处理技术和显示技术的飞速发展，早期非小细胞肺癌（NSCLC）的手术治疗方法在过去几年中取得了迅速进展。目前，NSCLC的金标准是肺叶切除术。在引入电视辅助胸腔镜手术（VATS）后，现在可以通过微创方式进行肺切除，这为患者带来了更好的预后，也为外科医生提供了更好的手术条件。最初，传统的二维（2D）系统使操作人员能够比开胸手术更近距离、放大且清晰地观察体腔内的情况。随着眼镜辅助三维（3D）和免眼镜3D显示系统的引入，多个视角得到进一步增强，从而出现了更稳定、更易于掌握且侵入性更小的电视辅助胸腔镜手术（VATS）。然而，鉴于标准VATS的可操作性和立体感有限，它限制了在更复杂病例中的应用。有望通过机器人辅助胸外科手术（RATS）克服标准VATS的大多数局限性。RATS系统由一个远程控制台和一个带有3或4个手臂的机器人单元组成，该单元可以复制外科医生的动作。此外，它为外科医生提供了放大的、三维和高清（HD）的手术视野，使他们能够进行更复杂的手术。除此之外，还结合现有的手术系统发明了一些新技术来解决难题。希望创新手术技术的较高成本能够被更好的患者预后和成本效益的提高所抵消。
