Ismail Mahmoud, Waterhouse Benjamin R, Colman Alyx, Gonzalez-Rivas Diego, Bosinceanu Mugurel, Dunning Joel
Ernst von Bergmann Medical Center, Potsdam, Germany.
Department of Thoracic Surgery, James Cook University Hospital, Middlesbrough, UK.
Ann Cardiothorac Surg. 2023 Mar 31;12(2):96-101. doi: 10.21037/acs-2022-urats-34. Epub 2023 Mar 30.
Uniportal robotic surgery was created by Dr. Diego Gonzalez-Rivas as a fusion of his decade of experience with uniportal video-assisted thoracoscopic surgery (VATS) and his recent experience with the Intuitive Robotic System. It represents, in his view, the natural evolution of the uniportal technique in the era of robotic surgery. In this article, we discuss some of the novel issues that this raises, including capacitive coupling, and we describe the technique in detail to help surgeons who may be interested in starting uniportal robotic surgery. We go through case selection, which should start with wedge resections and lymphadenectomy. We look at port placement, which is more posterior and lower than the usual uniportal VATS approach, and we discuss the optimal instruments and ports for the technique. We discuss the role of the assistant in uniportal robotic surgery, which is a key part of the operation as we regard this as a two-surgeon technique. We then discuss the future and other possible robotic platforms that might be suitable for uniportal robotic surgery. It is an exciting new development for robotic surgery, and we recommend that this technique is suitable for advanced surgeons who are experienced in uniportal VATS lobectomy and in multiportal robotic surgery.
单孔机器人手术由迭戈·冈萨雷斯 - 里瓦斯博士创立，它融合了他在单孔视频辅助胸腔镜手术（VATS）方面十年的经验以及他近期在直观机器人系统方面的经验。在他看来，这代表了机器人手术时代单孔技术的自然演进。在本文中，我们讨论了由此引发的一些新问题，包括电容耦合，并详细描述了该技术，以帮助那些可能有兴趣开展单孔机器人手术的外科医生。我们介绍了病例选择，应从楔形切除术和淋巴结清扫术开始。我们探讨了端口放置，它比常规单孔VATS方法更靠后且更低，还讨论了该技术的最佳器械和端口。我们讨论了助手在单孔机器人手术中的作用，由于我们将此视为一种双外科医生技术，所以这是手术的关键部分。然后我们讨论了单孔机器人手术的未来以及其他可能适用的机器人平台。这是机器人手术令人兴奋的新进展，我们建议该技术适用于在单孔VATS肺叶切除术和多孔机器人手术方面经验丰富的高级外科医生。
