Departement of General and Visceral Surgery, Klinikum Chemnitz gGmbH, Medical Campus of the Technische Universität Dresden, Chemnitz, Germany.
Surg Endosc. 2023 Jan;37(1):528-534. doi: 10.1007/s00464-022-09526-x. Epub 2022 Aug 24.
Robotic surgical systems introduce new opportunities for the minimal accessed surgeon. The combination of three-dimensional magnified vision and articulated instruments with seven degrees of freedom provide a good and safe alternative to laparoscopic surgery. Indeed some of these features may support the case that robotic surgery may be better than conventional surgery. In this study, we report our experience of robotic surgery by using the first open console, modular robotic platform in Germany, the Versius Surgical System®.
We implemented the Versius Surgical System® in April 2021 at our centre. Since then, 175 patients received robotic assisted surgery. All patients were included in this study. Data were analysed by using the SPSS (IBM Statistics) Software.
175 patients underwent robotic surgery. We started the implementation of the system by performing cholecystectomy. After the first 50 successful operations, we began to perform robotic assisted oncological resections. We saw a learning curve with improvements in total operative time and console time until reaching a standard similar to conventional laparoscopic surgery. The perioperative complication-ratio was equivalent for operations matched the histopathological outcome (MERCURY graduation, R0-staus) at oncological resections. However, four patients had to be revised because of secondary bleeding. Interestingly the total hospital stay for right sided hemicolectomy and oesophagus-resection was shorter than in laparoscopic surgery. In our opinion, the Versius Surgical System® seems to be a good, promising system and a safe alternative to other robotic systems, although any comparison is still missing. The open design enabling a better communication between console surgeon and bedside-unit assistant as well as the mobile bedside units are very interesting and allow more flexibility. Nevertheless, there are limitations of the system that require a direct comparison with other robotic systems as well as continuous advancement.
机器人手术系统为微创外科医生带来了新的机遇。三维放大的视觉和具有七个自由度的铰接器械的结合为腹腔镜手术提供了良好且安全的替代方案。事实上,其中一些特点可能支持机器人手术优于传统手术的观点。在本研究中,我们报告了使用德国首款开放式控制台、模块化机器人平台 Versius 手术系统®进行机器人手术的经验。
我们于 2021 年 4 月在我们的中心实施了 Versius 手术系统®。从那时起,已有 175 名患者接受了机器人辅助手术。所有患者均纳入本研究。使用 SPSS(IBM Statistics)软件对数据进行分析。
175 名患者接受了机器人手术。我们从胆囊切除术开始实施该系统。在完成前 50 例成功手术之后,我们开始进行机器人辅助肿瘤切除术。我们观察到手术总时间和控制台时间的学习曲线得到了改善,直到达到类似于传统腹腔镜手术的标准。在肿瘤切除术中,对于与组织病理学结果相匹配的手术(MERCURY 分级,R0 状态),手术相关并发症的比例相当。然而,有 4 名患者因继发性出血需要再次手术。有趣的是,右侧半结肠切除术和食管切除术的总住院时间短于腹腔镜手术。我们认为,Versius 手术系统®似乎是一种良好的、有前途的系统,是其他机器人系统的安全替代方案,尽管目前仍缺乏任何比较。开放式设计使控制台医生和床边单元助手之间能够更好地沟通,以及移动的床边单元,这些都非常有趣且具有更大的灵活性。然而,该系统存在一些限制,需要与其他机器人系统进行直接比较,并不断改进。