达芬奇机器人胰腺癌根治术与技巧

Robotic radical resection of pancreatic adenocarcinoma and the techniques

近十年来,应用达芬奇机器人手术系统行胰腺癌根治性手术在国内外逐渐得到开展。尽管达芬奇机器人手术系统是传统腹腔镜技术的突破,但与传统腹腔镜胰腺手术相比,应用机器人行胰腺手术在trocar孔布局、切除程序、淋巴结清扫以及消化道重建等方面仍不尽相同。机器人胰十二指肠切除术复杂、高危、昂贵,每一例均需严格认真对待,每一个微小和不经意的错误都有可能造成患者巨大的精神、身体创伤。为提高手术的安全性和规范化,本文以胰十二指肠切除术为例,重点介绍了机器人胰腺癌根治术的经验与技巧,希望笔者的经验可以给予学习曲线内的同行提供临床借鉴和帮助。

In the recent years, da Vinci robotic surgical system has been gradually applied in the radical resection of pancreatic adenocarcinoma around the world. Despite being a breakup of conventional laparoscopic surgery, the trocar placement, surgical procedures, lymphadenectomy and digestive reconstruction of robotic assisted laparoscopic resection is still different with conventional laparoscopic surgery. Considering the complexity, expense and high risk of robotic-assisted laparoscopic pancreaticoduodenectomy, it is extremely important to treat every case with great cautious, because every minor careless mistake might lead to huge mental and physical injury of the patient. To improve the safety and normalization of surgery, taking robotic assisted pancreaticoduodenectomy for example, we mainly discuss the surgical techniques and clinical experience of the robotic radical resection of pancreatic adenocarcinoma in this paper, which could serve as clinical help and reference for peers who are still in the learning curve.