达芬奇机器人直肠癌根治术的现状和发展

Updates and prospect of da Vinci robotic surgical system in radical resection of rectal cancer

达芬奇机器人手术是当前微创外科的最新潮流之一,它克服了传统腹腔镜的很多技术局限性,在提供立体视野、手术操作精细化和消除操作抖动等方面的优势显著。越来越多研究表明达芬奇机器人直肠癌手术安全可行。与传统腹腔镜手术相比较,机器人手术在降低中转开腹率、减少术后并发症率、改善术后生活质量等方面具有优势。在肿瘤远期生存方面,机器人术式与开腹手术、传统腹腔镜手术相当。近年来,机器人经自然腔道标本取出手术成为直肠癌治疗发展的重要分支。另外,在高速通信时代背景下,机器人系统将成为远程医疗的重点发展方向之一,积极推动远程会诊、学术交流、医院建设甚至就医模式的革新。

Introduction of the da Vinci robotic surgical system has revolutionized the field of minimally invasive surgery for rectal cancer.Da Vinci robotic technologies could help surgeons overcome the technical difficulties of conventional laparoscopic surgery showing significant superiority in aspects of 3D visualization articulated instruments and filtering operating tremor.Accumulated studies have confirmed the safety and feasibility of the da Vinci robotic surgery for rectal cancer.Compared with conventional laparoscopic surgery the da Vinci robotic rectal surgery has latent advantage in decreasing conversion rate reducing postoperative morbidity and improving postoperative life quality.In terms of oncological outcome the robotic rectal surgery has shown comparable long term outcomes with either open or laparoscopic surgery.At present,natural orifice specimen extraction surgery(NOSES)has been an important branch of robotic rectal surgery.In addition,in the era of high-speed communication,the robotic surgical system would be a key module in telemedicine,actively promoting the innovation of remote consultation,academic communication,hospital construction and even medical treatment model。