Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Louisville, Kentucky.
Surg Technol Int. 2021 Jun 28;39:232-240.
Robotic systems provide a platform for surgeons to expand their capabilities, allowing them to perform complex procedures safely and efficiently. Within the field of benign gynecology, this has become an increasingly popular option since receiving Food and Drug Administration (FDA) approval in 2005. However, the appropriate indications for robotic versus laparoscopic surgery continue to be debated.
Literature was reviewed to provide a comprehensive, evidence-based evaluation of the advantages and pitfalls of robotic surgery, the applications of robotic surgery for benign gynecologic procedures in comparison to conventional laparoscopy, and the role of robotic surgery as an educational tool.
Robotic surgery has favorable outcomes for surgeons in the areas of ergonomics, dexterity, and fatigue. Cost comparisons are widely varied and elaborate. Most patient outcomes are comparable between robotic and laparoscopic hysterectomies and endometriosis resections. In patients with a body mass index >30mg/m2 and uteri >750mg, hysterectomy outcomes are improved when surgery is done robotically. The use of the robotic system may be beneficial for patients undergoing myomectomy. Robotic surgery confers advantages for trainees and novice surgeons. There is no consensus on a standardized curriculum for robotic training or credentialing process for experienced surgeons.
Robotic surgery has distinct features that make it a valuable tool for gynecologic surgeons. There are no clear indications regarding when a robotic route should be chosen but could be considered when above average complexity is anticipated and when training new surgeons.
机器人系统为外科医生提供了一个扩展能力的平台，使他们能够安全有效地进行复杂的手术。在良性妇科领域，自 2005 年获得美国食品和药物管理局 (FDA) 批准以来，这已成为一种越来越受欢迎的选择。然而，机器人手术与腹腔镜手术的适当适应证仍存在争议。
对文献进行了回顾，以提供机器人手术的优势和缺陷、机器人手术在良性妇科手术中的应用与传统腹腔镜手术的比较以及机器人手术作为教育工具的全面、基于证据的评估。
机器人手术在手术的人体工程学、灵巧性和疲劳方面对外科医生有良好的效果。成本比较差异很大，且非常详细。机器人和腹腔镜子宫切除术和子宫内膜异位症切除术的大多数患者结局相似。对于 BMI>30mg/m2 和子宫>750mg 的患者，手术采用机器人方式时，子宫切除术的结局得到改善。对于接受子宫肌瘤切除术的患者，使用机器人系统可能是有益的。机器人手术为学员和新手外科医生带来优势。对于机器人培训的标准化课程或经验丰富的外科医生的认证流程尚未达成共识。
机器人手术具有独特的特点，使其成为妇科外科医生的有价值工具。目前还没有明确的指征表明何时应选择机器人手术，但当预期手术具有较高的复杂性，并且培训新外科医生时，可以考虑使用机器人手术。
