机器人辅助与传统单孔腹腔镜手术在妇科领域的应用

Application of robot-assisted and conventional laparoendoscopic single-site surgery in gynecology

随着腔镜技术不断发展和妇科医生腔镜手术技能的不断提高,妇科手术越来越微创化,使得以前必须开腹的手术而现在腹腔镜下就能达到同样的治疗效果,甚至由于腹腔镜的优势,该手术效果会更好。随着腹腔镜技术不断发展,腹腔镜手术变得越来越微创化,由传统的腹腔镜逐步发展到单孔腹腔镜(Laparoendoscopic single-site,LESS),再发展到经自然腔道腹腔镜手术(Natural orifice transumbilical endoscopic surgery,NOTES)。妇科常用的手术是经阴道自然腔道腹腔镜手术(Transvaginal natural orifice transumbilical endoscopic surgery,vNOTES),医疗技术的每一次进步总是建立在良好的手术效果之上,需要妇科医生更高的手术技能。近年来,机器人技术已广泛应用于妇科腹腔镜手术,其优点包括:高清3D手术视野,机械臂及手腕更加灵活、稳定、精准,操作更舒适,可以进行远程手术。本文对妇科传统单孔腹腔镜手术(Laparoendoscopic single-site,LESS)和机器人辅助单孔腹腔镜手术(Robot-assisted laparoendoscopic single-site,R-LESS)的研究进行综述,从而为妇科医生在临床工作中选择合适的手术方式提供参考。

With the development of endoscopic technology and improvement of surgery skills of gynecologists,gynecological surgeries are becoming more and more minimally invasive.Laparoendoscopic surgery can achieve the same effect as laparotomy,or even better due to its advantages over laparotomy.From conventional laparoscopic surgery to laparoendoscopic single-site surgery(LESS),and to natural orifice transluminal endoscopic surgery(NOTES),laparoendoscopic surgery is becoming more and more minimally invasive with technology development.In recent years,robotic surgery system has been widely used in gynecology.With 3D high-definition view,more flexible,stable and precise arms,it has achieved good surgical results in gynecology.The surgeon can even perform surgeries by sitting beside the console,which can greatly relieve fatigue and ensure surgical safety,and telesurgery can be realized.This review aims to provide references for gynecologists by analyzing the advantages and disadvantages of robot-assisted and conventional laparoendoscopic single-site surgery in gynecology.