Singh Tejinder P, Zaman Jessica, Cutler Jessica
Department of Surgery Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA.
World J Surg. 2021 Dec;45(12):3484-3492. doi: 10.1007/s00268-021-06321-y. Epub 2021 Oct 11.
For the last 20 years, controversies in robotic surgery focused on cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics [Leal Ghezzi and Campos in World J Surg 40:2550-2557, 2016].
This review explores the robotic systems which are currently indicated for use or development in gastrointestinal/abdominal surgery. These systems are reviewed and analyzed for clinical impact in these areas. In a MEDLINE search of articles with the search terms abdominal, gastrointestinal, review and robotic surgery, a total of 4306 total articles as of 2021 were assessed. Publicly available information, highest cited articles and reviews were assessed by the authors to determine the most significant regarding clinical outcomes.
Despite this increased number of articles related to robotic surgery, ongoing controversies have led to limitation in the use of current and future robotic surgery platforms [Connelly et al. in J Robotic Surg 14:155-165, 2020]. Newer robotic platforms have limited studies or analysis that would allow meaningful definite conclusions. A multitude of new scenarios are possible due to this limited information.
Robotic surgery is in evolution to a larger conceptual field of computationally enhanced surgery (CES). Various terms have been used in the literature including computer-assisted surgery or digital Surgery [Ranev and Teixeira in Surg Clin North Am 100:209-218, 2020]. With the growth of technological changes inherent in CES, the ability to validate these improvements in outcomes will require new metrics and analytic tools. This learning feedback and metric analysis will generate the new opportunities in simulation, training and application [Julian and Smith in Int J Med Robot 15:e2037, 2019].
在过去20年里，机器人手术的争议集中在降低成本、新平台和技术的开发、课程和虚拟模拟器的创建与验证，以及开展随机临床试验以确定机器人技术的最佳应用[Leal Ghezzi和Campos，《世界外科杂志》40:2550 - 2557，2016年]。
本综述探讨了目前适用于胃肠/腹部手术或正在开发的机器人系统。对这些系统在这些领域的临床影响进行了综述和分析。在MEDLINE数据库中搜索包含腹部、胃肠、综述和机器人手术等检索词的文章，截至2021年共评估了4306篇文章。作者评估了公开可用信息、被引用次数最多的文章和综述，以确定与临床结果最相关的内容。
尽管与机器人手术相关的文章数量有所增加，但持续存在的争议导致当前和未来机器人手术平台的使用受到限制[Connelly等人，《机器人手术杂志》14:155 - 165，2020年]。较新的机器人平台的研究或分析有限，无法得出有意义的明确结论。由于信息有限，可能会出现多种新情况。
机器人手术正在向计算增强手术（CES）这一更大的概念领域发展。文献中使用了各种术语，包括计算机辅助手术或数字手术[Ranev和Teixeira，《北美外科临床杂志》100:209 - 218，2020年]。随着CES中固有技术变革的发展，验证这些结果改善的能力将需要新的指标和分析工具。这种学习反馈和指标分析将在模拟、培训和应用方面产生新的机会[Julian和Smith，《国际医疗机器人杂志》15:e2037，2019年]。
