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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]. 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]. 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。

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