机器人胃肠道手术的初步应用浅见

Application of robotic system in gastrointestinal surgery

手术机器人是外科医生的手术辅助系统．目前以达芬奇机器人手术系统应用最为广泛。复旦大学附属中山医院自2009年10月开始应用达芬奇机器人手术系统施行胃肠道手术共计27例（其中胃手术18例．结直肠手术9例）。术前准确分期对于达芬奇机器人手术系统适应证的把握十分重要。达芬奇机器人手术系统对于术中淋巴结清扫、神经保护和直肠系膜的完整切除有着明显的优势。采用何种吻合方式（腹腔内或腹腔外）取决于手术方式和术者经验。虽然，达芬奇机器人手术系统的应用还存在一些不足．昂贵的价格也限制其推广。但是．相信其会成为外科发展的趋势。

Robotic system helps surgeons in performing surgery. Currently Da Vinci system is the most popular. Da Vinci system has been used for the stomach and bowel diseases in 27 cases （18 cases of stomach and 9 cases of colon and rectum） in the Zhongshan Hospital, Fudan University. Accurate preoperative staging is crucial, and Da Vinci system is advantageous in lymph node dissection, preservation of nerve plexus, and complete resection of mesorectum. Adoption of gastrointestinal tract reconstruction technique should depend on the operation and experience in surgery. Though Da Vinci system has limitations and the cost is high, it is believed to be the future trend.