机器手辅助下腔镜手术在小儿外科的应用

Applying robot-assisted endoscopy to pediatric surgery

目的 探讨机器手在辅助小儿腹腔镜及胸腔镜手术中的应用。方法 应用美国摩星公司生产的AESOP3000第四代机器手臂,持镜辅助小儿腹腔镜手术4例及胸腔镜手术2例。结果 6例手术均顺利完成,机器手能够按照术者指令准确持镜、移动到位、图像稳定,手术时间与非机器手辅助腔镜手术的时间接近或略缩短。并未增加手术风险。结论 AESOP3000第四代机器手具有智能化、人性化的特点,能够达到人机合一,可提供清晰图像,减轻人工扶镜不稳所致的术者视觉疲劳,使手术更安全,对患者未造成手术风险以外的附加危险,值得推广应用。其不足之处是不能自行完成擦镜工作及自行跟踪移动,价格较昂贵等。

Objective To discuss application of robotic system to laparoscopic and thoracoscopic surgery in children. Methods From April 2003 to June 2003, six cases (male 4, female 2) underwent robot-assisted endoscopic operation by AESOP 3000 robot (produced by Computer Motion) in which 4 cases had laparoscopic operation and 2 thoracoscopic operation. The age ranged from 2 months to 11years. The kind of operation of the former included impalpable testes (1), nephrectomy of polycystic kidney (1), nephroureterectomy of macro - hydroureterosis (1), resection of nephroureteral duplication (1), and the latter consisted of biopsy of mediastinum neoplasm (1) and removal of chest wall tumor (1). Results All operations were completed under robot-assisted endoscopy. The robot could control the laparoscope accu- rately and move to the position according to verbal command with steady images. The operating time was similar to or less than that of non-robotic laparoscopic operation. Conclusions Potential advantages of AE- SOP 3000 are more intellectual and reasonable, and provide for consistent, steady and safe images. The faults are not automatical tracing and cleaning away the telescope, and too expensive.