手术机器人系统和腹腔镜微创外科技术在胃癌治疗中的应用

Current status and future perspectives of robotic surgeryand laparoscopic surgery for gastric cancer

腹腔镜外科在胃癌治疗中面临着两大困难，即D2淋巴结清扫及全腹腔镜下的消化道重建。而手术机器人系统具有图像立体三维、放大10倍、有7个自由度关节的器械和医生工作体位舒适等优点，有利于行胃癌D2淋巴结清扫及消化道吻合重建．增强微创手术的优势，拓展微创外科在胃癌治疗中的适应证。在加速康复外科理念下开展微创手术治疗胃癌，必将有利于促进患者的快速康复。

Laparoscopic gastrectomy has not become a common procedure for gastric cancer due to the difficulties of performing D2 lymphadenectomy and reconstruction of digestive tract by the conventional laparoscopic instruments. The da Vinci system provides 3D visualization, enhanced magnification, and seven degrees of freedom of the instruments to suture and knot in the narrow surgical space, so it can perform totally robotic gastrectomy with D2 lymphadenectomy and robot-sewing anastomosis for reconstruction. Application of robotic system can expand the indications of minimally invasive surgery in treatment of gastric cancer. Combination fast-track surgery to optimize the perioperative management with the technique of minimally invasive surgery can enhance the recovery of surgical gastric cancer patients.