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推进机器人单孔胆囊切除术:创新、挑战与未来方向。

Advancing Robotic Single-Site Cholecystectomy: Innovations, Challenges, and Future Directions.

作者信息

Ansari Ubaid, Syed Burhaan, Sedighi Romteen, Ansari Khadija, Akhtar Muzammil, Davies Yinka

机构信息

Neurology, California Northstate University College of Medicine, Elk Grove, USA.

Radiology, California Northstate University College of Medicine, Elk Grove, USA.

出版信息

Cureus. 2024 May 20;16(5):e60643. doi: 10.7759/cureus.60643. eCollection 2024 May.

Abstract

The crystalization of the components of bile within the gallbladder can lead to the formation of gallstones (cholelithiasis), which may often require surgical removal of the gallbladder, a procedure known as cholecystectomy, in symptomatic cases. Robotic single-site cholecystectomy (RSSC) is a recently introduced groundbreaking minimally invasive procedure for gallbladder removal. RSSC utilizes robotic technology, offering enhanced dexterity through a single-incision approach, promising improved outcomes such as reduced postoperative pain and superior cosmesis. However, certain limitations, such as restricted instrument movement and heightened hernia risk, necessitate a critical evaluation of this modality. Furthermore, as the widespread adoption of RSSC remains undecided due to concerns over its costs, efficiency, and overall superiority over prior models, this paper assesses future possibilities for RSSC's evolution. In vivo robotics, improved digital imaging, and re-engineering of the surgical instruments themselves are all potential avenues to augment the current RSSC design, although it is currently unclear as to what extent they could impact the procedure's viability. This review critically examines the available literature on the effectiveness and potency of RSSC compared to its predecessors in the modern healthcare setting and proposes future directions through which innovation could more firmly establish the procedure as the standard of care for cholecystectomy.

摘要

胆囊内胆汁成分的结晶可导致胆结石(胆石症)的形成,在出现症状的情况下,胆结石通常需要通过手术切除胆囊,即所谓的胆囊切除术。机器人单孔胆囊切除术(RSSC)是最近推出的一种开创性的微创胆囊切除手术。RSSC利用机器人技术,通过单切口方法提高了灵活性,有望改善术后疼痛减轻和美容效果更好等结果。然而,某些限制,如器械运动受限和疝气风险增加,需要对这种手术方式进行严格评估。此外,由于对其成本、效率以及相对于以往模式的总体优势存在担忧,RSSC的广泛应用仍未确定,本文评估了RSSC未来发展的可能性。体内机器人技术、改进的数字成像以及手术器械本身的重新设计都是增强当前RSSC设计的潜在途径,尽管目前尚不清楚它们对该手术可行性的影响程度。这篇综述批判性地审视了现有文献中关于RSSC与现代医疗环境中其前身相比的有效性和优势,并提出了未来的发展方向,通过创新可以更牢固地将该手术确立为胆囊切除术的护理标准。

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Single-site robotic cholecystectomy.单部位机器人胆囊切除术
JSLS. 2014 Jul-Sep;18(3). doi: 10.4293/JSLS.2014.00266.

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