Adachi Tomohiko, Hara Takanobu, Matsushima Hajime, Soyama Akihiko, Eguchi Susumu
Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
Ann Gastroenterol Surg. 2024 Jun 21;8(5):774-777. doi: 10.1002/ags3.12817. eCollection 2024 Sep.
The liver requires careful handling intra-operatively owing to its vital functions and complexity. Traditional open hepatectomy, while standard, is invasive and requires long recovery periods. Laparoscopic hepatectomy is a less invasive option, with its own challenges. The rise of robotic surgery, such as the da Vinci® system, improves precision and control, addressing the limitations of conventional methods, but brings new concerns, such as costs and training. This review focuses on the latest advancements in robotic hepatectomy from 2022/23 articles, delving into topics like "robotic surgery in liver transplantation," "robotic hepatectomy for hilar cholangiocarcinoma," "robotic vascular reconstruction following hepatectomy," "robotic repeat hepatectomy," and "prospective trials in robotic hepatectomy." To retrieve articles, a focused literature search was conducted using PubMed for articles from 2022/23 with a 5-year filter, excluding reviews. Initially, abstracts were screened, and relevant articles on robotic surgery were examined in full for inclusion in this review. Although all the above items are cutting-edge, and many of the references are necessarily at the level of case reports, recent articles are still accompanied by surgical videos, which are useful to readers, especially surgeons who are considering imitating the procedures. In summary, we examined the recent advancements in robotic liver resection. The inclusion of videos that present new techniques aids in knowledge transfer. We anticipate the continued growth of this field of research.
由于肝脏的重要功能和复杂性,术中需要小心处理。传统的开放性肝切除术虽是标准术式,但具有侵入性,且恢复时间长。腹腔镜肝切除术是一种侵入性较小的选择,但也有其自身的挑战。机器人手术的兴起,如达芬奇®系统,提高了精准度和可控性,克服了传统方法的局限性,但也带来了新的问题,如成本和培训。本综述聚焦于2022/23年文章中机器人肝切除术的最新进展,深入探讨“肝移植中的机器人手术”“肝门部胆管癌的机器人肝切除术”“肝切除术后的机器人血管重建”“机器人再次肝切除术”以及“机器人肝切除术的前瞻性试验”等主题。为检索文章,使用PubMed对2022/23年的文章进行了有针对性的文献搜索,并设置了5年的筛选条件,排除综述。最初先筛选摘要,然后对有关机器人手术的相关文章进行全文审查,以纳入本综述。尽管上述所有内容都是前沿的,而且许多参考文献必然处于病例报告的水平,但最近的文章仍配有手术视频,这对读者很有用,尤其是那些考虑模仿这些手术的外科医生。总之,我们研究了机器人肝切除的最新进展。包含展示新技术的视频有助于知识传播。我们预计该研究领域将持续发展。