Alawfi Homoud, Kim Ho Seung, Yang Seung Yoon, Kim Nam Kyu
King Abdul Aziz Medical City, Riyadh, Saudi Arabia.
Department of Surgery, Division of Colorectal Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722 Korea.
Indian J Surg Oncol. 2020 Dec;11(4):552-564. doi: 10.1007/s13193-020-01109-3. Epub 2020 Jun 4.
Surgical techniques have evolved over the past few decades, and minimally invasive surgery has been rapidly adapted to become a preferred operative approach for treating colorectal diseases. However, many of the procedures remain a technical challenge for surgeons to perform laparoscopically, which has prompted the development of robotic platforms. Robotic surgery has been introduced as the latest advance in minimally invasive surgery. The present article provides an overview of robotic rectal surgery and describes many advances that have been made in the field over the past two decades. More specifically, the introduction of the robotic platform and its benefits, and the limitations of current robotic technology, are discussed. Although the main advantages of robotic surgery over conventional laparoscopy appear to be lower conversion rates and better surgical specimen quality, oncological and functional outcomes appear to be similar to those of other alternatives. Other potential benefits include earlier recovery of voiding and sexual function after robotic total mesorectal excision. Nevertheless, the costs and lack of haptic feedback remain the primary limitations to the widespread use of robotic technology in the field.
在过去几十年里,外科技术不断发展,微创手术已迅速成为治疗结直肠疾病的首选手术方式。然而,许多手术在腹腔镜下进行对外科医生来说仍是一项技术挑战,这促使了机器人平台的发展。机器人手术作为微创手术的最新进展被引入。本文概述了机器人直肠手术,并描述了过去二十年来该领域取得的许多进展。更具体地说,讨论了机器人平台的引入及其优势,以及当前机器人技术的局限性。尽管机器人手术相对于传统腹腔镜手术的主要优势似乎是较低的中转率和更好的手术标本质量,但肿瘤学和功能结局似乎与其他替代方法相似。其他潜在益处包括机器人全直肠系膜切除术后排尿和性功能的更早恢复。然而,成本和缺乏触觉反馈仍然是该领域广泛使用机器人技术的主要限制因素。