Ali Fadwa, Raskin Elizabeth
Division of Colon and Rectal Surgery, Department of Surgery University of California Davis Medical Center, Sacramento, CA.
Clin Colon Rectal Surg. 2021 Sep;34(5):297-301. doi: 10.1055/s-0041-1729863. Epub 2021 Sep 3.
Diverticular disease is common, and increasing in prevalence worldwide. The treatment for acute and chronic diverticular disease has a huge clinical and economic burden. Surgery is standard for complicated diverticulitis, and there are several benefits to using robotic surgery in these cases. Complicated diverticular disease can result in fistula, fibrosis, and deranged anatomy, which present technical challenges to the surgeon. Understanding and anticipating these anatomical challenges is key to successful surgery. While fears of conversion in complicated cases may stop surgeons from using traditional laparoscopic surgery, robotic surgery is especially promising for enhancing dexterity, visualization, and facilitating completely minimally invasive surgery in these complicated cases. In this chapter, we review end-to-end technical strategies of robotic colorectal surgery for complicated diverticular disease, including cases with colovesicular, colovaginal, and colocutaneous fistulae.
憩室病很常见，且在全球范围内患病率不断上升。急慢性憩室病的治疗带来了巨大的临床和经济负担。手术是复杂性憩室炎的标准治疗方法，在这些病例中使用机器人手术有诸多益处。复杂性憩室病可导致瘘管、纤维化和解剖结构紊乱，给外科医生带来技术挑战。了解并预见这些解剖学挑战是手术成功的关键。虽然在复杂病例中对中转开腹的担忧可能会使外科医生不敢使用传统腹腔镜手术，但机器人手术在增强灵活性、可视化以及在这些复杂病例中促进完全微创手术方面特别有前景。在本章中，我们回顾了针对复杂性憩室病的机器人结直肠手术的端到端技术策略，包括伴有结肠膀胱瘘、结肠阴道瘘和结肠皮肤瘘的病例。
