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中华肝脏外科手术学电子杂志 ›› 2022, Vol. 11 ›› Issue (05) : 429 -432. doi: 10.3877/cma.j.issn.2095-3232.2022.05.001

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机器人手术在胰腺外科中的应用进展与争议
罗文浩1, 曹喆1, 张太平1,()   
  1. 1. 100730 中国医学科学院北京协和医院基本外科
  • 收稿日期:2022-05-22 出版日期:2022-10-10
  • 通信作者: 张太平
  • 基金资助:
    国家自然科学基金面上项目(81802475,81972258,81974376,82103016,82172836)

Development and depate of robotic surgery in pancreatic surgery

Wenhao Luo1, Zhe Cao1, Taiping Zhang1()   

  • Received:2022-05-22 Published:2022-10-10
  • Corresponding author: Taiping Zhang
引用本文:

罗文浩, 曹喆, 张太平. 机器人手术在胰腺外科中的应用进展与争议[J/OL]. 中华肝脏外科手术学电子杂志, 2022, 11(05): 429-432.

Wenhao Luo, Zhe Cao, Taiping Zhang. Development and depate of robotic surgery in pancreatic surgery[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2022, 11(05): 429-432.

目前对于胰腺外科而言,手术切除仍为主要的治疗方式。近年来随着科技不断发展,胰腺外科的手术治疗措施日新月异,使外科手术朝着更加精准及高效的方向前进。传统开腹手术切口大、涉及脏器多、手术时间长,对患者造成较大的创伤。机器人辅助手术系统为胰腺外科提供了新的技术选择。早在2002年达芬奇机器人系统便应用于胰腺手术[1]。机器人辅助手术系统通过计算机控制系统实施复杂的微创精准外科手术,其优势在于医师可以远离手术台进行远距离手术操作,手术更精准,且术中采用三维高清立体视觉,手眼协调,自动过滤掉主刀操作者的手部颤动。对于技术难度要求更高的胰腺相关手术而言,其不但缓解了术者的疲劳,而且能在腹膜后狭小深在的空间进行精准解剖、内镜下缝合及显微吻合等操作,使解剖、分离、切除等精细化操作更为简便。美国外科医师学院国家外科质量改进计划通过调查发现机器人胰十二指肠切除术(robotic pancreaticoduodenectomy,RPD)和腹腔镜胰十二指肠切除术(LPD)两者开展例数占比相同[2]。目前针对胰腺疾病患者选择腹腔镜还是机器人手术仍存在争议。本文通过回顾国内外机器人胰腺外科手术最新研究进展,探讨其手术适应证、学习曲线、有效性及安全性等关键问题,以期为我国胰腺外科开展机器人手术提供思路。

[13]
Chen S, Zhan Q, Chen JZ, et al. Robotic approach improves spleen-preserving rate and shortens postoperative hospital stay of laparoscopic distal pancreatectomy: a matched cohort study[J]. Surg Endosc, 2015, 29(12):3507-3518.
[14]
Zhou JY, Xin C, Mou YP, et al. Robotic versus laparoscopic distal pancreatectomy: a meta-analysis of short-term outcomes[J]. PLoS One, 2016, 11(3):e0151189.
[15]
Daouadi M, Zureikat AH, Zenati MS, et al. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique[J]. Ann Surg, 2013, 257(1):128-132.
[16]
Butturini G, Damoli I, Crepaz L, et al. A prospective non-randomised single-center study comparing laparoscopic and robotic distal pancreatectomy[J]. Surg Endosc, 2015, 29(11):3163-3170.
[17]
Abu Hilal M, Hamdan M, Di Fabio F, et al. Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study[J]. Surg Endosc, 2012, 26(6):1670-1674.
[18]
Raoof M, Nota CLMA, Melstrom LG, et al. Oncologic outcomes after robot-assisted versus laparoscopic distal pancreatectomy: analysis of the national cancer database[J]. J Surg Oncol, 2018, 118(4):651-656.
[19]
Xourafas D, Ashley SW, Clancy TE. Comparison of perioperative outcomes between open, laparoscopic, and robotic distal pancreatectomy: an analysis of 1 815 patients from the ACS-NSQIP procedure-targeted pancreatectomy database[J]. J Gastrointest Surg, 2017, 21(9):1442-1452.
[20]
Ocuin LM, Miller-Ocuin JL, Novak SM, et al. Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival[J]. HPB, 2016, 18(10):835-842.
[21]
Boggi U, Palladino S, Massimetti G, et al. Laparoscopic robot-assisted versus open total pancreatectomy: a case-matched study[J]. Surg Endosc, 2015, 29(6):1425-1432.
[22]
Tian F, Hong XF, Wu WM, et al. Propensity score-matched analysis of robotic versus open surgical enucleation for small pancreatic neuroendocrine tumours[J]. Br J Surg, 2016, 103(10):1358-1364.
[23]
Jin JB, Qin K, Li H, et al. Robotic enucleation for benign or borderline tumours of the pancreas: a retrospective analysis and comparison from a high-volume centre in Asia[J]. World J Surg, 2016, 40(12):3009-3020.
[24]
周陈杰, 王杰钦, 高毅. 浅谈腹腔镜保留器官功能的胰腺切除术[J/CD].中华普通外科学文献(电子版), 2020, 14(2):81-83.
[25]
Chen S, Zhan Q, Jin JB, et al. Robot-assisted laparoscopic versus open middle pancreatectomy: short-term results of a randomized controlled trial[J]. Surg Endosc, 2017, 31(2):962-971.
[26]
Shi Y, Jin J, Huo Z, et al. An 8-year single-center study: 170 cases of middle pancreatectomy, including 110 cases of robot-assisted middle pancreatectomy[J]. Surgery, 2020, 167(2): 436-441.
[27]
沈柏用,詹茜,邓侠兴, 等. 机器人手术系统在胰腺中段切除术中的应用[J]. 腹腔镜外科杂志, 2012, 17(7):481-484.
[28]
Liu R, Wakabayashi G, Palanivelu C, et al. International consensus statement on robotic pancreatic surgery[J]. Hepatobiliary Surg Nutr, 2019, 8(4):345-360.
[29]
Chapman BC, Gajdos C, Hosokawa P, et al. Comparison of laparoscopic to open pancreaticoduodenectomy in elderly patients with pancreatic adenocarcinoma[J]. Surg Endosc, 2018, 32(5):2239-2248.
[1]
Melvin WS, Needleman BJ, Krause KR, et al. Computer-enhanced robotic telesurgery. initial experience in foregut surgery[J]. Surg Endosc, 2002, 16(12):1790-1792.
[2]
Xourafas D, Pawlik TM, Cloyd JM. Independent predictors of increased operative time and hospital length of stay are consistent across different surgical approaches to pancreatoduodenectomy[J]. J Gastrointest Surg, 2018, 22(11):1911-1919.
[3]
Giulianotti PC, Sbrana F, Bianco FM, et al. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience[J]. Surg Endosc, 2010, 24(7):1646-1657.
[4]
周宁新. 达芬奇机器人胰十二指肠切除手术要点[J/CD]. 中华普外科手术学杂志(电子版), 2010, 4(3):240-245.
[5]
Liao CH, Wu YT, Liu YY, et al. Systemic review of the feasibility and advantage of minimally invasive pancreaticoduodenectomy[J]. World J Surg, 2016, 40(5):1218-1225.
[6]
Chen S, Chen JZ, Zhan Q, et al. Robot-assisted laparoscopic versus open pancreaticoduodenectomy: a prospective, matched, mid-term follow-up study[J]. Surg Endosc, 2015, 29(12):3698-3711.
[7]
Liu R, Zhang T, Zhao ZM, et al. The surgical outcomes of robot-assisted laparoscopic pancreaticoduodenectomy versus laparoscopic pancreaticoduodenectomy for periampullary neoplasms: acomparative study of a single center[J]. Surg Endosc, 2017, 31(6):2380-2386.
[8]
Zhao W, Liu C, Li S, et al. Safety and efficacy for robot-assisted versus open pancreaticoduodenectomy and distal pancreatectomy: a systematic review and meta-analysis[J]. Surg Oncol, 2018, 27(3):468-478.
[9]
Polanco PM, Zenati MS, Hogg ME, et al. An analysis of risk factors for pancreatic fistula after robotic pancreaticoduodenectomy: outcomes from a consecutive series of standardized pancreatic reconstructions[J]. Surg Endosc, 2016, 30(4):1523-1529.
[10]
Shi Y, Jin J, Qiu W, et al. Short-term outcomes after robot-assisted vs open pancreaticoduodenectomy after the learning curve[J]. JAMA Surg, 2020, 155(5):389-394.
[11]
杨景瑞, 陈梦闽, 邓侠兴, 等. 机器人手术系统联合血管切除重建行胰十二指肠切除术的17例疗效评价(附手术视频)[J]. 四川大学学报(医学版), 2020, 51(4):462-466.
[12]
Melvin WS, Needleman BJ, Krause KR, et al. Robotic resection of pancreatic neuroendocrine tumor[J]. J Laparoendosc Adv Surg Tech A, 2003, 13(1):33-36.
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