机器人胃癌切除消化道重建的质量控制

Quality control of digestive tract reconstruction after robotic gastrectomy

机器人手术系统以其高清放大术野、过滤手震颤和多自由度可转腕机械臂等特点,在胃癌切除手术和消化道重建中具有一定优势。目前,对于机器人胃癌切除术后消化道重建方式的选择及规范应用仍存在争议。为规范机器人胃癌切除术后消化道重建的选择和实施,本文围绕机器人胃癌切除术后消化道重建这一话题,阐述了消化道重建前的质量控制、适应证的掌握、消化道重建的原则以及消化道重建后并发症预防和管理等多个环节;重点评述了机器人辅助消化道重建和全腔内消化道重建的操作细节,包括手工缝合技术、直线切割闭合器线性吻合技术和圆形吻合器圆形吻合技术;同时对新技术在机器人胃癌术后消化道重建中的应用潜力进行了展望。

With features such as high-definition magnification of the surgical field,filtering of hand tremor,and robotic arm with multi-degree-of-freedom rotatable wrist,surgical robot has unique advantages in various aspects of digestive tract reconstruction(DTR)after robotic gastrectomy(RG).Currently,there is still controversy about the selection and standardized application of DTR after RG for gastric cancer.To standardize the selection and implementation of DTR,we describe various aspects of quality control before DTR,selection of indications,principles of DTR,and prevention and management of postoperative complications of DTR.We also comment on the operation details of robotic-assisted and total robotic DTR,including manual suture,linear anastomosis with linear stapler,and circular anastomosis with circular stapler.Meanwhile,we propose our prospects on the potential application of new technology in robotic DTR for gastric cancer.