Zhang Qingyi, Ma Honghai, Ke Lei, He Zhehao, Zhou Chunlin, Lv Wang, Hu Jian, Wang Luming
Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China.
College of Control Science and Engineering, Zhejiang University, Hangzhou, 310063, China.
Sci Rep. 2025 Feb 15;15(1):5606. doi: 10.1038/s41598-025-89897-y.
The detection of pulmonary nodules is increasing every year, as well as the need for surgical treatment in more patients, which places a significant burden on surgeons. Surgeon fatigue not only increases surgical risk, but also poses a health hazard to the surgeons. How to reduce surgeon fatigue is an important issue that needs to be addressed urgently.
We collected 917 patients who underwent thoracoscopic surgery between 2022 and 2023. They were categorized into thoracoscopy group, mechanical arm group and pneumatic arm group according to the procedure. Data related to the perioperative period (operative time, blood loss, serious adverse events, etc.) of different patients were retrospectively analyzed. The related scale of fatigue index was also designed to quantify and analyze the fatigue index of doctors.
There were 316, 302 and 299 patients in the thoracoscopic, mechanical and pneumatic arm groups, respectively. There was no statistically significant difference in operative time, bleeding, mean length of hospital stay, and serious adverse events among the three groups. Although there was no significant difference in overall surgical fatigue scores among the three groups, the use of robotic and pneumatic arms significantly reduced the fatigue of surgeons and assistants in complicated surgeries.
Compared to traditional thoracoscopic surgery, the application of surgical assistance robotic arm does not increase perioperative risk. Moreover, in longer thoracoscopic procedures, it significantly reduces fatigue for both the surgeons and their assistants. However, current robotic arms still have certain limitations and require continuous improvements to better meet clinical demands.
每年肺部结节的检出率都在上升,需要手术治疗的患者也越来越多,这给外科医生带来了巨大负担。外科医生疲劳不仅会增加手术风险,还会对医生的健康构成危害。如何减轻外科医生的疲劳是一个亟待解决的重要问题。
我们收集了2022年至2023年间接受胸腔镜手术的917例患者。根据手术方式将他们分为胸腔镜组、机械臂组和气动臂组。对不同患者围手术期(手术时间、失血量、严重不良事件等)的数据进行回顾性分析。还设计了疲劳指数相关量表来量化和分析医生的疲劳指数。
胸腔镜组、机械臂组和气动臂组分别有316例、302例和299例患者。三组在手术时间、出血量、平均住院时间和严重不良事件方面无统计学显著差异。虽然三组总体手术疲劳评分无显著差异,但在复杂手术中,使用机器人手臂和气动臂显著减轻了外科医生和助手的疲劳。
与传统胸腔镜手术相比,手术辅助机器人手臂的应用不会增加围手术期风险。此外,在较长的胸腔镜手术中,它能显著减轻外科医生及其助手的疲劳。然而,目前的机器人手臂仍有一定局限性,需要不断改进以更好地满足临床需求。