腹腔镜和达芬奇机器人辅助下结直肠癌手术的功能保存

Function-preserving in colorectal cancer surgery assisted by laparoscopy and da Vinci robotic surgical system

微创手术是目前治疗结直肠癌的主流术式,功能保存则是近几年关于手术治疗的讨论热点之一。与开腹手术相比,腹腔镜手术和达芬奇机器人手术更加契合微创、“无血”、功能保存的外科理念。本文从可视性外科技术、手术操作性损伤、自主神经的保留、保留肛门括约肌功能手术、整体整合医学理念与经自然腔道取标本手术、精准的术前评估与新技术的应用等方面,围绕腹腔镜和达芬奇机器人辅助下结直肠癌手术的功能保存的相关问题展开讨论,与同道交流。

Minimally invasive surgery has become the mainstream approach for treating colorectal cancer,with functionpreserving being a focal point of recent surgical discussions.Compared with open surgery,laparoscopic surgery and da Vinci robotic surgery align more closely with the surgical principles of minimal invasion,“bloodlessness”,and functionpreserving.This article delves into the aspects of function-preserving in laparoscopic and da Vinci robot-assisted colorectal cancer surgery,including visual surgical techniques,surgical manipulation-related injuries,preservation of autonomous nerves,sphincter-preserving surgery,holistic integrative medicine concept and natural orifice specimen extraction surgery,and precise preoperative evaluation and the application of novel technologies.The aim is to share insights with colleagues in the field.