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机器人结肠切除术的艺术:过去 5 年进展综述。

The art of robotic colonic resection: a review of progress in the past 5 years.

机构信息

Department of General Surgery II, the First Medical Center of Chinese PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.

Department of Hepatobiliary Surgery II, the First Medical Center of Chinese PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.

出版信息

Updates Surg. 2021 Jun;73(3):1037-1048. doi: 10.1007/s13304-020-00969-2. Epub 2021 Jan 22.

Abstract

Surgery is developing in the direction of minimal invasiveness, and robotic surgery is becoming increasingly adopted in colonic resection procedures. The ergonomic improvements of robot promote surgical performance, reduce workload for surgeons and benefit patients. Compared with laparoscopy-assisted colon surgery, the robotic approach has the advantages of shorter length of hospital stay, lower rate of conversion to open surgery, and lower rate of intraoperative complications for short-term outcomes. Synchronous robotic liver resection with colon cancer is feasible. The introduction of the da Vinci Xi System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) has introduced more flexibility to colonic operations. Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection. Single-port robotic colectomy reduces the number of robotic ports for better looking and faster recovery. Intestinal anastomosis methods using totally robotic surgery result in shorter time to bowel function recovery and tolerance to a solid diet, although the operative time is longer. Indocyanine green is used as a tracer to assess blood supplementation in the anastomosis and marks lymph nodes during operation. The introduction of new surgical robots from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes. The present article reviews recent advances in robotic colonic resection over the past five years.

摘要

手术正朝着微创化的方向发展,机器人手术在结肠切除术式中越来越多地被采用。机器人的人机工程学改进促进了手术效果,降低了外科医生的工作负荷,使患者受益。与腹腔镜辅助结肠手术相比,机器人手术在短期结果方面具有住院时间更短、中转开放手术率更低和术中并发症发生率更低的优势。同期机器人肝切除术与结肠癌手术是可行的。达芬奇 Xi 系统(直觉外科公司,加利福尼亚州森尼韦尔)的引入为结肠手术带来了更大的灵活性。优化耻骨上手术入路可能会缩短接受机器人结肠切除术患者的住院时间。单孔机器人结肠切除术减少了机器人端口的数量,使患者的外观更好,恢复更快。虽然手术时间更长,但使用全机器人手术进行肠吻合的方法可使肠道功能恢复和耐受固体饮食的时间更短。吲哚菁绿被用作评估吻合术中血液补充的示踪剂,并在手术中标记淋巴结。来自多家制造商的新型手术机器人的引入必将改变机器人手术的格局,并产生高质量的手术结果。本文综述了过去五年中机器人结肠切除术的最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e98/8184527/5a7920f9e367/13304_2020_969_Fig1_HTML.jpg

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