机器人经肛微创手术的现状与展望

Application status and prospects of robotic transanal minimally invasive surgery

经肛微创手术已广泛应用于直肠良性疾病和部分恶性肿瘤的手术治疗。但无论是经肛门内镜显微手术、经肛门微创手术还是经肛全直肠系膜切除术,在肛门直肠狭小空间内操作时的难度与相对较长的学习曲线制约了这些术式的发展。机器人手术系统克服了传统腹腔镜的许多缺点,尤其在狭小空间的操作优势为经肛微创外科的发展带来了新的活力。近年来,关于机器人手术的研究不断增多,在手术可行性、安全性、术后短期结局等方面已经取得了一些初步的结果。本文以达芬奇机器人系统为主,简要阐述手术机器人在经肛微创手术中的应用现状与发展前景。

Transanal minimally invasive surgery(TAMIS)has been widely applied in the surgical treatment of benign rectal diseases and some malignant tumors.However,regardless of whether it is transanal endoscopic microsurgery(TEM),transanal minimally invasive surgery(TAMIS),or transanal total mesorectal excision(taTME),the difficulty of operating in the narrow space of the anorectum and the relatively long learning curve have constrained the development of these surgical techniques.The robotic surgical system overcomes many limitations of traditional laparoscopy,particularly its advantages in narrow spaces,which have brought new vitality to the development of transanal minimally invasive surgery.In recent years,research on robotic surgery has continued to increase,with some preliminary results achieved in terms of surgical feasibility,safety,and short-term postoperative outcomes.This article briefly elaborates on the current application status and development prospects of surgical robots in TAMIS,focusing primarily on the da Vinci®robotic system.