Friedman Garrett, Rodriguez Miguel
Division of Colon and Rectal Surgery, Mountain View Hospital, Las Vegas, Nevada.
Department of Surgery, Sunrise GME Health Consortium, Las Vegas, Nevada.
Clin Colon Rectal Surg. 2023 Aug 21;37(5):289-294. doi: 10.1055/s-0043-1770942. eCollection 2024 Sep.
Transanal minimally invasive surgery (TAMIS) can be utilized to manage a wide variety of rectal lesions but can be technically demanding with traditional laparoscopic equipment. Robotic platforms such as the da Vinci Single Port system can reduce the technical barriers of TAMIS and allow more complicated lesions to be addressed. Robotic TAMIS with the SP system follows similar indications for local excision of benign and malignant lesions as conventional TAMIS or even transanal endoscopic microsurgery. We describe our initial experience using the SP system and provide technical suggestions for how to incorporate this technology. We also address innovations in flexible endoscopic robotic surgery that we anticipate will allow for increased use of organ preservation of the colon and rectum, as well as possibly expand the use of natural orifice surgery.
经肛门微创手术(TAMIS)可用于处理多种直肠病变,但使用传统腹腔镜设备时对技术要求较高。达芬奇单孔系统等机器人平台可降低TAMIS的技术障碍,并能处理更复杂的病变。使用单孔系统的机器人TAMIS与传统TAMIS甚至经肛门内镜显微手术在良性和恶性病变局部切除方面遵循相似的适应证。我们描述了使用单孔系统的初步经验,并提供了如何应用这项技术的技术建议。我们还探讨了柔性内镜机器人手术的创新,预计这将增加结肠和直肠器官保留的应用,并可能扩大自然腔道手术的应用。