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良性上尿路梗阻的机器人重建:当前文献综述

Robotic reconstruction for benign upper urinary tract obstruction: a review of the current literature.

作者信息

Gonzalez Jauregui Rebeca, Bhalla Rohan G, Doersch Karen, Flynn Brian J

机构信息

Division of Urology, Department of Surgery, Anschutz Medical Center, University of Colorado, Academic Office One Bldg, 12631 East 17th Ave., Box C319, Room L15-5602, Aurora, CO 80045, USA.

Division of Urology, Department of Surgery, Anschutz Medical Center, University of Colorado, Aurora, CO, USA.

出版信息

Ther Adv Urol. 2025 Mar 18;17:17562872251326785. doi: 10.1177/17562872251326785. eCollection 2025 Jan-Dec.

Abstract

The field of reconstructive urology has seen a paradigm shift in the surgical approach for intra-abdominal cases, resulting in an increased preference for minimally invasive techniques. The introduction of the surgical robot has led to exponential growth in innovative approaches, reflecting the ongoing efforts to improve patient outcomes and address the limitations of open and laparoscopic surgery. This review article summarizes the knowledge gained in the last 10 years about adult robotic ureteral reconstruction. A non-systematic literature review was conducted on February 18, 2024 using Medline, PubMed, Web of Science, and Embase libraries. Studies published in English since 2014 reporting at least five robotic ureteral reconstructive cases for the management of benign ureteral obstruction in adults were included. A narrative review focusing on robotic ureteral reconstructive techniques, their associated success and complication rates, and how the robotic approach compares to open and laparoscopic reconstruction was performed. The current literature demonstrates increased utilization of the robotic platform in reconstructive urological procedures. Robotic surgery has been shown to be associated with shorter learning curves, lower surgeon fatigue, better visualization and equivalent results to those seen with laparoscopic surgery. While the literature is limited by a lack of comparative data, well-designed randomized controlled trials, and standardized criteria for defining and measuring success, this review demonstrates the safety, feasibility, and efficacy of robotic ureteral reconstruction for managing benign ureteral strictures, confirming it as a viable alternative to open and laparoscopic surgery.

摘要

重建泌尿外科领域在腹腔内病例的手术方法上发生了范式转变,导致对微创技术的偏好增加。手术机器人的引入使创新方法呈指数级增长,这反映了为改善患者预后以及解决开放手术和腹腔镜手术局限性所做的持续努力。这篇综述文章总结了过去10年中在成人机器人输尿管重建方面所获得的知识。2024年2月18日使用Medline、PubMed、Web of Science和Embase数据库进行了非系统性文献综述。纳入了自2014年以来以英文发表的、报告至少5例用于治疗成人良性输尿管梗阻的机器人输尿管重建病例的研究。进行了一项叙述性综述,重点关注机器人输尿管重建技术、其相关的成功率和并发症发生率,以及机器人手术方法与开放手术和腹腔镜重建相比情况如何。当前文献表明,机器人平台在重建泌尿外科手术中的应用有所增加。机器人手术已被证明学习曲线较短、术者疲劳度较低、视野更好,且与腹腔镜手术效果相当。虽然现有文献因缺乏对比数据、精心设计的随机对照试验以及定义和衡量成功的标准化标准而受到限制,但本综述证明了机器人输尿管重建治疗良性输尿管狭窄的安全性、可行性和有效性,证实其是开放手术和腹腔镜手术的可行替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/065c/11921008/e43d7efa412c/10.1177_17562872251326785-fig1.jpg

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