Coco Danilo, Leanza Silvana
Department of General, Robotic, Oncologic Surgery, Giglio Hospital Foundation, Cefalù, Italy.
J Robot Surg. 2025 Sep 5;19(1):558. doi: 10.1007/s11701-025-02657-y.
This comprehensive systematic review assesses the clinical outcomes of robotic-assisted procedures for acute abdominal emergencies, analyzing data from 27 studies comprising 1142 cases. The investigation specifically examines five critical emergency conditions: complicated appendicitis (representing 32.5% of cases), acute cholecystitis (28.7%), small bowel obstruction (15.2%), perforated peptic ulcers (9.8%), and acute diverticulitis (7.4%). Analysis reveals robotic procedures averaged 152 min (± 38) in duration, with an overall conversion rate of 9.1%. Complication rates showed no significant difference from laparoscopic methods (13.2% versus 14.7%, p = 0.21). The data highlight two significant robotic advantages: improved intraoperative hemostasis (85 mL versus 120 mL average blood loss, p = 0.03) and lower conversion rates among obese patients (11.3% versus 18.6%, p = 0.04). These findings indicate that robotic systems may provide distinct technical benefits for specific emergency scenarios while delivering safety outcomes equivalent to traditional minimally invasive surgery.
这项全面的系统评价评估了机器人辅助手术治疗急性腹部急症的临床结果，分析了来自27项研究的1142例病例的数据。该调查特别检查了五种关键的紧急情况：复杂性阑尾炎（占病例的32.5%）、急性胆囊炎（28.7%）、小肠梗阻（15.2%）、消化性溃疡穿孔（9.8%）和急性憩室炎（7.4%）。分析显示，机器人手术平均持续时间为152分钟（±38），总体转换率为9.1%。并发症发生率与腹腔镜手术方法无显著差异（13.2%对14.7%，p = 0.21）。数据突出了机器人的两个显著优势：术中止血改善（平均失血量85毫升对120毫升，p = 0.03）和肥胖患者的转换率较低（11.3%对18.6%，p = 0.04）。这些发现表明，机器人系统在为特定紧急情况提供独特技术优势的同时，能实现与传统微创手术相当的安全结果。
