Lee Jihyun, Kim Seongmin
Gynecologic Cancer Center, CHA Ilsan Medical Center, CHA University College of Medicine, 1205 Jungang-ro, Ilsandong-gu, Goyang-si 10414, Gyeonggi-do, Republic of Korea.
Life (Basel). 2024 Aug 5;14(8):982. doi: 10.3390/life14080982.
Endometriosis is a chronic condition affecting approximately 10% of women of reproductive age, leading to significant physical and emotional stress. Treatments include medical management and surgical interventions, with laparoscopic surgery being the gold standard for removing endometrial tissue. The advent of robotic-assisted laparoscopic surgery (RALS) has enabled more complex procedures to be performed minimally invasively, increasing its use in high-difficulty surgeries. Developed in the late 20th century, systems like the Da Vinci Surgical System have revolutionized surgery by enhancing precision, dexterity, and visualization. The latest models, including the Da Vinci Xi and SP, offer advanced features such as enhanced arm mobility, fluorescence imaging, and single-port capabilities. Comparative studies of RALS and conventional laparoscopy (LPS) for endometriosis show mixed results. While some studies indicate no significant differences in complications or recovery outcomes, others highlight longer operative times and hospital stays for RALS. Despite these drawbacks, RALS is not inferior to LPS overall. The clinical benefits of RALS include greater precision and accuracy, reduced surgeon fatigue, and a faster learning curve, facilitated by advanced ergonomic and control systems. However, the high costs and extensive infrastructure requirements limit the accessibility and availability of robotic surgery, particularly in smaller or rural hospitals. The absence of tactile feedback remains a challenge, though upcoming advancements aim to address this. Continued research and development are essential to make robotic surgery more cost-effective and broadly accessible, ensuring its benefits can reach a wider patient population. This abstract encapsulates the key aspects of robotic surgery's development, comparative studies with conventional methods, and its clinical benefits and limitations, highlighting the need for ongoing improvements and research.
子宫内膜异位症是一种慢性疾病，影响着约10%的育龄女性，会导致严重的身心压力。治疗方法包括药物治疗和手术干预，其中腹腔镜手术是切除子宫内膜组织的金标准。机器人辅助腹腔镜手术（RALS）的出现使更复杂的手术能够以微创方式进行，在高难度手术中的应用日益增加。像达芬奇手术系统这样在20世纪末开发的系统，通过提高精准度、灵活性和可视化程度，给手术带来了变革。最新的型号，包括达芬奇Xi和SP，具有增强的手臂灵活性、荧光成像和单孔功能等先进特性。对RALS和传统腹腔镜手术（LPS）治疗子宫内膜异位症的比较研究结果不一。虽然一些研究表明在并发症或恢复结果方面没有显著差异，但其他研究则强调RALS的手术时间和住院时间更长。尽管存在这些缺点，但总体而言RALS并不逊色于LPS。RALS的临床优势包括更高的精准度和准确性、减少外科医生的疲劳以及更快的学习曲线，这得益于先进的人体工程学和控制系统。然而，高昂的成本和广泛的基础设施要求限制了机器人手术的可及性和可用性，尤其是在较小的或农村医院。缺乏触觉反馈仍然是一个挑战，不过即将到来的进展旨在解决这一问题。持续的研发对于使机器人手术更具成本效益并更广泛地可用至关重要，以确保其益处能够惠及更广泛的患者群体。本摘要概括了机器人手术的发展、与传统方法的比较研究、其临床优势和局限性等关键方面，强调了持续改进和研究的必要性。
