不同入路达芬奇机器人在甲状腺切除术中的应用进展

Application progress of da Vinci robot via different approaches in thyroidectomy

目的总结不同手术入路达芬奇机器人手术系统在甲状腺切除术中的优点与缺点。方法检索国内外不同手术入路达芬奇机器人甲状腺切除术研究的相关文献并予以综述。结果经腋窝入路的手术方式疗效确切,技术成熟;经双侧腋窝-乳晕入路应用范围广,适用于初学者;经耳后入路在颈侧区淋巴结清扫中具有很大优势;经口腔入路是符合“微创”理念的手术入路。结论不同手术入路达芬奇机器人甲状腺切除术都有其相应的应用范围及优势,临床中手术医师应依据患者的肿瘤位置、大小、数量等因素并结合术者自身条件来选择现有医疗条件下的最佳手术入路方式,以达到肿瘤根治和降低损伤的治疗效果。

Objective To summarize the advantages and disadvantages of different surgical approaches in thyroidectomy using the da Vinci robotic surgical system.Method The relevant to articles about da Vinci robotic thyroidectomy via different surgical approaches at home and abroad were retrieved and reviewed.Results The robotassisted transaxillary thyroidectomy had a definite curative effect and was a mature technology.The bilateral axillarybreast approach thyroidectomy had a wide range of applications and was suitable for beginners.The robotic retroauricular approach thyroidectomy had great advantages in the dissection of lateral cervical lymph nodes.The transoral robotic thyroidectomy was a surgical approach that conformed to the minimally invasive concept.Conclusions Da Vinci robotic thyroidectomy via different surgical approaches has its corresponding application scope and advantages.Clinical surgeons should choose an optimal surgical approach according to the tumor location,size and number of patients and the advantages of the operator,so as to achieve the therapeutic effect of radical cure of tumors and reduction of injury.