Ikoma Naruhiko, Mansfield Paul F, Badgwell Brian D
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1484, Houston, TX, 77030, USA.
J Gastrointest Surg. 2021 May;25(5):1354-1356. doi: 10.1007/s11605-021-04979-2. Epub 2021 Mar 16.
Minimally invasive surgery techniques have evolved remarkably over the past few decades in the field of surgical oncology, including robotic techniques for gastric malignancies. Bedside surgical assistance is often limited by operating table space or surgeon availability. Operating surgeons need to understand such limitations in robotic surgery assistance and how to maximize the effective use of the inactive 4th robotic arm (i.e., determine “where to park the 4th arm”) to obtain adequate exposure of the surgical field during robotic gastrectomy. In this video, we demonstrate how we perform robotic total gastrectomy, with a focus on how we effectively utilize the 4th robotic arm to achieve adequate exposure of the surgical field. Achieving excellent exposure of the surgical field is of paramount importance during robotic total gastrectomy for gastric cancer, and the effective use of the 4th robotic arm is extremely important for improving the safety and oncologic quality of robotic total gastrectomy.
在过去几十年里，微创外科手术技术在外科肿瘤学领域取得了显著进展，包括用于胃癌的机器人技术。床边手术辅助常常受到手术台空间或外科医生可用性的限制。手术医生需要了解机器人手术辅助中的此类限制，以及如何最大限度地有效利用闲置的第四机械臂（即确定“第四臂停放位置”），以便在机器人胃癌切除术中获得手术视野的充分暴露。在本视频中，我们展示了如何进行机器人全胃切除术，重点是我们如何有效利用第四机械臂来实现手术视野的充分暴露。在机器人胃癌全胃切除术中，实现手术视野的良好暴露至关重要，而有效使用第四机械臂对于提高机器人全胃切除术的安全性和肿瘤学质量极为重要。
