Nakata Kohei, Nakamura Masafumi
Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
Ann Gastroenterol Surg. 2021 Mar 4;5(4):467-476. doi: 10.1002/ags3.12446. eCollection 2021 Jul.
Robotic surgery has emerged as an alternative to laparoscopic surgery and it has also been applied to pancreatectomy. With the increase in the number of robotic pancreatectomies, several studies comparing robotic pancreatectomy and conventional open or laparoscopic pancreatectomy have been published. However, the use of robotic pancreatectomy remains controversial. In this review, we aimed to provide a comprehensive overview of the current status of robotic pancreatectomy. Various aspects of robotic pancreatectomy and conventional open or laparoscopic pancreatectomy are compared, including the benefits, limitations, oncological efficacy, learning curves, and costs. Both robotic pancreatoduodenectomy and distal pancreatectomy have favorable or comparable outcomes to conventional procedures, and robotic pancreatectomy has the potential to be an alternative to open or laparoscopic procedures. However, there are still several disadvantages to robotic platforms, such as prolonged operative duration and the high cost of the procedure. These disadvantages will be improved by developing instruments, overcoming the learning curve, and increasing the number of robotic pancreatectomies. In addition, robotic pancreatectomy is still in the introductory period in most centers and should only be used in accordance with strict indications.
机器人手术已成为腹腔镜手术的替代方法，并且也已应用于胰腺切除术。随着机器人胰腺切除术数量的增加，已经发表了几项比较机器人胰腺切除术与传统开放或腹腔镜胰腺切除术的研究。然而，机器人胰腺切除术的应用仍存在争议。在本综述中，我们旨在全面概述机器人胰腺切除术的现状。对机器人胰腺切除术与传统开放或腹腔镜胰腺切除术的各个方面进行了比较，包括益处、局限性、肿瘤学疗效、学习曲线和成本。机器人胰十二指肠切除术和远端胰腺切除术与传统手术相比均有良好或相当的结果，并且机器人胰腺切除术有可能成为开放或腹腔镜手术的替代方法。然而，机器人平台仍存在一些缺点，比如手术时间延长和手术成本高昂。通过开发器械、克服学习曲线以及增加机器人胰腺切除术的数量，这些缺点将会得到改善。此外，在大多数中心，机器人胰腺切除术仍处于引入阶段，应仅在严格的适应症下使用。
