Uk Bae Sung
Department of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, Korea.
J Anus Rectum Colon. 2022 Oct 27;6(4):221-230. doi: 10.23922/jarc.2022-047. eCollection 2022.
Robotic surgical systems were created in part to solve several constraints of laparoscopic surgery and offer technical advantages. With a substantial body of evidence that demonstrates its efficacy in the treatment of rectal cancer, robotic surgery will soon become another conventional treatment. However, further investigations and randomized trials focusing on primary endpoints are needed to establish some advantages for robot-assisted colon surgery. Da Vinci Single-Site and SP platforms were developed to overcome the shortcomings of single-port laparoscopic surgery. Despite the currently insufficient evidence, it appears that the SP platform addresses many of the limitations of single-port transabdominal or transanal surgery. Robotic transanal minimally invasive surgery and total mesorectal excision were developed to overcome some of the limitations of conventional platforms, using wristed instrumentation to enhance dexterity and ergonomics. Studies on the effectiveness and viability of this novel approach are ongoing. The near-infrared fluorescence technique, real-time stereotactic navigation technology, and other surgical data platforms based on artificial intelligence incorporated into the robotic system will play an important role in improving outcomes. Robotic systems for advanced colorectal cancer offer technical advantages for complex and precise surgeries. If the cost of robotic surgery is reduced by expanding its indications and enhancing competition among different robotic platforms, it will provide clinical benefits to more patients and reduce social healthcare costs.
机器人手术系统的创建部分是为了解决腹腔镜手术的若干限制并提供技术优势。有大量证据表明其在直肠癌治疗中的有效性，机器人手术很快将成为另一种常规治疗方法。然而，需要进一步的研究和以主要终点为重点的随机试验，以确立机器人辅助结肠手术的一些优势。达芬奇单孔和SP平台的开发是为了克服单孔腹腔镜手术的缺点。尽管目前证据不足，但SP平台似乎解决了单孔经腹或经肛门手术的许多局限性。机器人经肛门微创手术和全直肠系膜切除术的开发是为了克服传统平台的一些局限性，使用腕式器械来提高灵活性和人体工程学性能。关于这种新方法的有效性和可行性的研究正在进行中。纳入机器人系统的近红外荧光技术、实时立体定向导航技术以及其他基于人工智能的手术数据平台将在改善手术结果方面发挥重要作用。用于晚期结直肠癌的机器人系统为复杂和精确的手术提供技术优势。如果通过扩大机器人手术的适应症并加强不同机器人平台之间的竞争来降低其成本，它将为更多患者带来临床益处并降低社会医疗成本。
