Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Department of Surgery, NorthShore University HealthSystem, Walgreens Building, Floor 2, 2650 Ridge Road, Evanston, IL, 60201, USA.
Updates Surg. 2021 Jun;73(3):799-814. doi: 10.1007/s13304-021-00973-0. Epub 2021 Jan 23.
The use of the robotic platform for gastrointestinal surgery was introduced nearly 20 years ago. However, significant growth and advancement has occurred primarily in the last decade. This is due to several advantages over traditional laparoscopic surgery allowing for more complex dissections and reconstructions. Several randomized controlled trials and retrospective reviews have demonstrated equivalent oncologic outcomes compared to open surgery with improved short-term outcomes. Unfortunately, there are currently no universally accepted or implemented training programs for robotic surgery and robotic surgery experience varies greatly. Additionally, several limitations to the robotic platform exist resulting in a distinct learning curve associated with various procedures. Therefore, implementation of robotic surgery requires a multidisciplinary team approach with commitment and investment from clinical faculty, operating room staff and hospital administrators. Additionally, there is a need for wider distribution of educational modules to train more surgeons and reduce the associated learning curve. This article will focus on the implementation of the robotic platform for surgery of the pancreas, stomach, liver, colon and rectum with an emphasis on the associated learning curve, educational platforms to develop proficiency and perioperative outcomes.
机器人平台在胃肠外科的应用在近 20 年前就已被引入。然而，其主要的发展和进步是在过去十年中发生的。这是因为与传统腹腔镜手术相比，机器人手术具有几个优势，能够进行更复杂的解剖和重建。多项随机对照试验和回顾性研究表明，机器人手术与开放手术相比具有同等的肿瘤学效果，并且具有更好的短期效果。不幸的是，目前还没有普遍接受或实施的机器人手术培训计划，机器人手术的经验也有很大差异。此外，机器人平台存在一些局限性，导致与各种手术相关的学习曲线明显。因此，机器人手术的实施需要一个多学科团队的方法，需要临床教师、手术室工作人员和医院管理人员的承诺和投资。此外，还需要更广泛地分发教育模块，以培训更多的外科医生，并降低相关的学习曲线。本文将重点介绍机器人平台在胰腺、胃、肝、结肠和直肠手术中的应用，重点介绍相关的学习曲线、提高熟练度的教育平台以及围手术期结果。
