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儿科机器人手术:叙述性综述。

Paediatric robotic surgery: a narrative review.

机构信息

Department of Paediatric Surgery, Children's Health Ireland at Crumlin, Dublin, Ireland.

Department of Colorectal Surgery, University Hospital Limerick, St Nessan's Road, Dooradoyle, Limerick, Co Limerick, Ireland.

出版信息

J Robot Surg. 2023 Aug;17(4):1171-1179. doi: 10.1007/s11701-023-01523-z. Epub 2023 Jan 16.

Abstract

The benefits of minimally invasive surgery (MIS) compared with traditional open surgery, including reduced postoperative pain and a reduced length of stay, are well recognised. A significant barrier for MIS in paediatric populations has been the technical challenge posed by laparoscopic surgery in small working spaces, where rigid instruments and restrictive working angles act as barriers to safe dissection. Thus, open surgery remains commonplace in paediatrics, particularly for complex major surgery and for surgical oncology. Robotic surgical platforms have been designed to overcome the limitations of laparoscopic surgery by offering a stable 3-dimensional view, improved ergonomics and greater range of motion. Such advantages may be particularly beneficial in paediatric surgery by empowering the surgeon to perform MIS in the smaller working spaces found in children, particularly in cases that may demand intracorporeal suturing and anastomosis. However, some reservations have been raised regarding the utilisation of robotic platforms in children, including elevated cost, an increased operative time and a lack of dedicated paediatric equipment. This article aims to review the current role of robotics within the field of paediatric surgery.

摘要

与传统的开放手术相比,微创手术(MIS)具有减少术后疼痛和缩短住院时间等优势,这一点已得到广泛认可。在儿科人群中,MIS 面临的一个重大障碍是腹腔镜手术在小工作空间中带来的技术挑战,其中刚性器械和受限的工作角度成为安全解剖的障碍。因此,开放手术在儿科仍然很常见,特别是对于复杂的大型手术和外科肿瘤学。机器人手术平台旨在通过提供稳定的三维视图、改善人机工程学和更大的运动范围来克服腹腔镜手术的局限性。这些优势在儿科手术中可能特别有益,因为它使外科医生能够在儿童较小的工作空间中进行 MIS,特别是在可能需要进行体内缝合和吻合的情况下。然而,人们对机器人平台在儿童中的应用提出了一些保留意见,包括成本增加、手术时间延长以及缺乏专用的儿科设备。本文旨在综述机器人技术在小儿外科学领域的当前作用。

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