[1]郝迎学,张荣杰.机器人手术系统在血管外科中的应用与展望[J].第三军医大学学报,2019,41(24):2366-2369.
 HAO Yingxue,ZHANG Rongjie.Application and prospect of robotic surgical system in vascular surgery[J].J Third Mil Med Univ,2019,41(24):2366-2369.
点击复制

机器人手术系统在血管外科中的应用与展望(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第24期
页码:
2366-2369
栏目:
专题报道
出版日期:
2019-12-31

文章信息/Info

Title:
Application and prospect of robotic surgical system in vascular surgery
作者:
郝迎学 张荣杰
陆军军医大学(第三军医大学)第一附属医院血管外科
Author(s):
HAO Yingxue ZHANG Rongjie

Department of Vascular Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
 

关键词:
机器人手术系统血管外科血管疾病微创手术
Keywords:
robotic surgical system vascular surgery vascular disease minimally invasive surgery
分类号:
R319; R654.3
文献标志码:
A
摘要:

机器人手术系统对破坏性手术为主的、平时手术野较深、显露较困难的患者有明显优势,如泌尿科、妇产科的手术。主要是以瘤体或结石的取出为主;对于修复、成型手术类难度仍然较大。因此机器人手术系统目前在血管外科虽有尝试和探索,但并没有得到广泛的开展,但作为探索仍然具有科学意义和临床意义。机器人手术系统在血管外科的应用刚刚起步,还有许多领域需要不断地探索和规范,包括手术适应证,关键技术和规范流程,术中、术后并发症的处理等。更为重要的是要开展机器人手术与开放手术和腹腔镜手术在血管系统疾病中应用的临床研究,加强随诊观察,特别是远期疗效的观察,为机器人手术系统在血管外科的广泛应用提供依据。机器人手术系统目前存在诸如缺乏触觉反馈、机械臂庞大、机械臂相互之间容易互相干扰等问题,还需加强器具研发和临床研究,争取使之造福更多血管疾病患者。

Abstract:

The robotic surgical system has been widely used in surgeries in various fields for its advantages over human eyes and hands with a magnified, stereoscopic view, flexible manipulation and ability to filter tiny tremors. The application of the robotic surgical system in vascular surgery is still in its infancy, and many issues concerning the operation techniques and safety need to be explored, especially in terms of the indications, key techniques, standardized procedures and management of intra- and post-operative complications. Of greater importance are the promotion of clinical studies that compare robotic surgical system versus open or laparoscopic surgery in vascular surgery and the collection and analysis of the long-term follow-up data. The evidence obtained from these studies will facilitate the wide application of robotic surgical system in vascular surgery. In addition, the defects in the current robotic surgical system need be improved, such as the lack of tactile feedback, the large size of the mechanical arm, and the interference between the arms. The era of robotic surgery has come, which urges greater efforts in both technical development and clinical studies of the robotic surgical system.

参考文献/References:

[1]GAO C Q, YANG M, WU Y, et al. Hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on beating heart and stent placement[J]. Ann Thorac Surg, 2009, 87(3): 737-741. DOI: 10.1016/j.athoracsur.2008.12.017.
[2]SHARMA N L, SHAH N C, NEAL D E. Robotic-assisted laparoscopic prostatectomy[J]. Br J Cancer, 2009, 101(9): 1491-1496. DOI: 10.1038/sj.bjc.6605341.
[3]CHEN C C, FALCONE T. Robotic gynecologic surgery: past, present, and future[J]. Clin Obstet Gynecol, 2009, 52(3): 335-343. DOI: 10.1097/GRF.0b013e3181b08adf.
[4]LOUIS G, HUBERT J, LADRIERE M, et al. Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation. An evaluation of 35 procedures[J].Nephrol Ther, 2009, 5(7): 623-630. DOI: 10.1016/j.nephro.2009.06.008.
[5]周宁新, 刘全达. 达芬奇系统在腹部外科的应用[J]. 腹部外科, 2009, 22(5): 261-262.
ZHOU N X, LIU Q D. Application of Da Vinci system in abdominal surgery [J]. J Abdom Surg, 2009, 22(5): 261-262.
[6]张荣杰, 孙龙, 杨世伟, 等. 达芬奇机器人手术系统辅助髂股静脉旁路移植术的临床疗效[J]. 中华消化外科杂志, 2019(4): 380-386.
ZHANG R J, SUN L, YANG S W, et al. Clinical efficacy of Da Vinci robot-assisted iliofemoral vein bypass grafting[J]. Chin J Dig Surg, 2019(4): 380-386.
[7]LOULMET D, CARPENTIER A, D’ATTELLIS N, et al. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments[J]. J Thorac Cardiovasc Surg, 1999, 118(1): 4-10. DOI: 10.1016/S0022-5223(99)70133-9.
[8]BONAROS N, SCHACHNER T, LEHR E, et al. Five hundred cases of robotic totally endoscopic coronary artery bypass grafting: predictors of success and safety[J]. Ann Thorac Surg, 2013, 95(3): 803-812. DOI: 10.1016/j.athoracsur.2012.09.071.
[9]WISSELINK W, CUESTA M A, GRACIA C, et al. Robot-assisted laparoscopicaortobifemoral bypass for aortoiliac occlusive disease: a report of two cases[J]. J Vasc Surg, 2002, 36(5): 1079-1082. DOI: 10.1067/mva.2002.128312.
[10]KOLVENBACH R, SCHWIERZ E, WASILLJEW S, et al. Total laparoscopically and robotically assisted aortic aneurysm surgery: a critical evaluation[J]. J Vasc Surg, 2004, 39(4): 771-776. DOI: 10.1016/j.jvs.2003.10.050.
[11]DESGRANGES P, BOURRIEZ A, JAVERLIAT I, et al. Robotically assistedaorto-femoral bypass grafting: lessons learned from our initial experience[J]. Eur J Vasc Endovasc Surg, 2004, 27(5): 507-511. DOI: 10.1016/j.ejvs.2004.01.002.
[12]STDLER P, DVORCEK L, VITSEK P, et al. Is robotic surgery appropriate for vascular procedures? Report of 100aortoiliac cases[J]. Eur J Vasc Endovasc Surg, 2008, 36(4): 401-404. DOI: 10.1016/j.ejvs.2008.06.028.
[13]TDLER P, DVORˇCˇEK L, VITSEK P, et al. Robot assisted aortic and non-aortic vascular operations[J].Eur J Vasc Endovasc Surg, 2016, 52(1): 22-28. DOI: 10.1016/j.ejvs.2016.02.016.

相似文献/References:

[1]谭文锋,杨康,廖克龙.食管癌侵犯主动脉的外科治疗[J].第三军医大学学报,2005,27(24):2453.
[2]刘鹏,彭学良,刘晋才,等.兔股动脉火器伤海水浸泡后的外科处理及其疗效[J].第三军医大学学报,2001,23(05):0.[doi:10.16016/j.1000-5404.2001.05.027 ]
 LIU Peng,PENG Xue liang,LIU Jin cai,et al.[J].J Third Mil Med Univ,2001,23(24):0.[doi:10.16016/j.1000-5404.2001.05.027 ]
[3].73—2型血管吻合器[J].第三军医大学学报,1979,01(03):0.[doi:10.16016/j.1000-5404.1979.03.010 ]

更新日期/Last Update: 2019-12-17