Ngu James Chi-Yong, Teo Nan-Zun
Department of Surgery, Colorectal Service, Changi General Hospital, Singapore, Singapore.
Int J Med Robot. 2022 Jun;18(3):e2367. doi: 10.1002/rcs.2367. Epub 2022 Jan 19.
An objective assessment of robotic assistance in hemicolectomies.
Robotic assistance has been objectively shown to be superior to conventional laparoscopy in anterior resections. This follow-up study analyzes the role of robotics in hemicolectomies.
Operative videos of laparoscopic and robotic hemicolectomies were reviewed. Only oncological resections were included. Two components were evaluated - scope holder performance and assistant instrument performance.
A total of 40 videos were reviewed. The cases were stratified in equal numbers based on method of surgery (robotic, laparoscopic), type of hemicolectomy (right, left), and seniority of the bedside assistant (specialist, non-specialist). The views achieved in robotic surgery were superior and less dependent on the bedside assistant. The degree of assistance provided by the robotic system was also more than that in the conventional laparoscopic group.
Robotics provides superior visualization and more dynamic assistance than conventional laparoscopy in hemicolectomies. This study demonstrates the technical advantage of robotic assistance, but not necessarily a superiority in clinical outcome.
对机器人辅助半结肠切除术进行客观评估。
客观研究表明,在低位前切除术方面,机器人辅助手术优于传统腹腔镜手术。本随访研究分析了机器人技术在半结肠切除术中的作用。
回顾了腹腔镜和机器人辅助半结肠切除术的手术视频。仅纳入肿瘤切除术。评估了两个部分——持镜器性能和辅助器械性能。
共回顾了40个视频。根据手术方式(机器人辅助、腹腔镜)、半结肠切除术类型(右半、左半)和床边助手资历(专科医生、非专科医生)将病例等数分层。机器人手术获得的视野更佳,且对床边助手的依赖更小。机器人系统提供的辅助程度也高于传统腹腔镜组。
在半结肠切除术中,机器人技术比传统腹腔镜手术能提供更好的视野和更灵活的辅助。本研究证明了机器人辅助的技术优势,但不一定意味着临床结局更优。