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腹腔镜与机器人:历史并行。

Laparoscopy & robotics: a historical parallel.

机构信息

- Colégio Brasileiro de Cirurgiões, Comissão de Cirurgia Minimamente Invasiva e Robótica - Porto Alegre - RS - Brasil.

出版信息

Rev Col Bras Cir. 2020 Nov 23;47:e20202811. doi: 10.1590/0100-6991e-20202811. eCollection 2020.

DOI:10.1590/0100-6991e-20202811
PMID:33237185
Abstract

The evolution of robotic platforms has brought up ethical, economic, educational, and clinical applicability issues that refer to the early 1990s, when laparoscopy began its dissemination as a technology that would revolutionize surgery. Introduced in Brazil since 1990, laparoscopy has received a lot of resistance from different sectors, including the medical academy itself. The technique was considered expensive, complex, poorly available and with limited clinical applications. However, in a short time, it was established as the gold standard for the treatment of most diseases in different organ systems and surgical specialties. At this time, similarly to laparoscopy, robotic surgery is expressed as a disruptive technology, determining an important breakdown of paradigms, and moving the wheel of history forward. The author draws a parallel in relation to the use of both technologies in the surgeon's armamentarium. The fear of the "new technology", seen when laparoscopy appeared, is repeated with the advent of robotic surgery. Laparoscopy and robotic surgery, at the same time, imposed new knowledge challenges for surgeons, anesthetists, nurses, engineers - the need to learn again, to develop new skills. The previous experience of implementing laparoscopy should always be remembered and considered, optimizing the current scenario of the robotic platform, in its introduction and dissemination with the surgical community. The advent of the "robotic era" and its evolutionary potential will continue to assist surgeons in their mission to serve their patients with quality and safety.

摘要

机器人平台的发展带来了伦理、经济、教育和临床适用性等问题,可以追溯到 20 世纪 90 年代初,当时腹腔镜技术开始传播,被认为将彻底改变外科手术。腹腔镜技术于 1990 年引入巴西,受到了包括医学界本身在内的不同领域的抵制。该技术被认为昂贵、复杂、难以获得且临床应用有限。然而,在短时间内,它已确立为治疗不同器官系统和外科专业大多数疾病的金标准。此时,与腹腔镜类似,机器人手术被视为一种颠覆性技术,确定了重要的范式突破,并推动了历史的车轮向前发展。作者在外科医生的武器库中对这两种技术的使用进行了类比。当腹腔镜出现时,人们对“新技术”的恐惧再次出现,而随着机器人手术的出现,这种恐惧再次出现。腹腔镜和机器人手术同时给外科医生、麻醉师、护士、工程师带来了新的知识挑战——需要重新学习,发展新技能。在引入和传播机器人平台时,应始终牢记和考虑腹腔镜的先前实施经验,以优化当前的机器人平台场景。“机器人时代”的到来及其进化潜力将继续帮助外科医生以质量和安全为患者服务。

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