Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review art...Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.展开更多
Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the ...Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called 'trifecta'. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.展开更多
Background: To investigate the learning curve of “robotic surgery” versus “conventional laparoscopy” in two trials of the FLS program in a population of medical students with no experience in laparoscopy. Methods:...Background: To investigate the learning curve of “robotic surgery” versus “conventional laparoscopy” in two trials of the FLS program in a population of medical students with no experience in laparoscopy. Methods: A prospective trial. Students, all novices in training and surgical practice, were randomized into 2 groups: the “traditional laparoscopy” group and the “robotic assistance” group. Students were evaluated during two tests from the FLS: peg transfer and intracorporeal knot tying. Results: The median laparoscopic knot completion time was significantly lower in the “robotic surgery” group (p = 0.038). Conclusions: Robotic assistance training in neophytes is effective in improving the completion time of laparoscopic knots.展开更多
目的探究达芬奇机器人在直肠癌全直肠系膜切除术中的应用效果。方法研究对象为2022年1月—2023年1月福建医科大学肿瘤临床医学院/福建省肿瘤医院收治的96例直肠癌拟行手术治疗的患者,采用计算机法将患者以0.001~0.096编号,0.001~0.048...目的探究达芬奇机器人在直肠癌全直肠系膜切除术中的应用效果。方法研究对象为2022年1月—2023年1月福建医科大学肿瘤临床医学院/福建省肿瘤医院收治的96例直肠癌拟行手术治疗的患者,采用计算机法将患者以0.001~0.096编号,0.001~0.048编号的患者为对照组,0.049~0.096编号的患者为观察组,每组各48例。对照组患者接受腹腔镜下全直肠系膜切除术,观察组采用达芬奇机器人行全直肠系膜切除术,对比不同手术方式患者手术相关指标、恢复情况、肿瘤学情况以及术后并发症的发生情况。结果两组手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量低于对照组(P<0.05);两组引流管留置时间比较,差异无统计学意义(P>0.05),观察组术后排气时间、首次流质饮食时间、术后住院时间短于对照组(P<0.05),观察组住院费用高于对照组(P<0.05);两组术后肿瘤病理分型、分级、国际抗癌联盟/美国癌症联合会(UN Economic and Social Council/American Joint Committee on Cancer,UICC/AJCC)分期以及淋巴结清扫数比较,差异无统计学意义(P>0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论直肠癌全直肠系膜切除术中,达芬奇机器人与腹腔镜均有较为显著的治疗效果和安全性,而达芬奇机器人术中出血量更低,术后胃肠道功能恢复更快,缩短患者的住院时间。展开更多
目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术...目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术(腹腔镜组).比较两组患者手术情况、术后恢复情况及术后并发症.结果:机器人组手术时间明显长于腹腔镜组(161.1 min±41.4 min vs 135.5 min±39.1m i n,P=0.001),术中出血量少于腹腔镜组(104.8 m L±70.8 m L vs 140.3 m L±81.4 m L,P=0.013),低位直肠癌的保肛率高于腹腔镜组[65.0%(13/20)vs 25.0%(4/16),P=0.017],排气时间、进流质时间、拔尿管时间均短于腹腔镜组(P<0.05),但住院费用明显高于腹腔镜组(2.7万元±1.1万元vs 4.3万元±1.3万元,P=0.000).两组手术均无中转开腹.两组在标本切除长度、肿瘤下缘距下切缘的长度、淋巴结清扫数目、术后住院时间和术后并发症发生率方面比较差异无统计意义(P>0.05).结论:达芬奇机器人直肠癌根治术取得与腹腔镜手术相同的根治效果,并具有创伤小、术中出血少、术后恢复快、保肛率高等优势,可作为治疗直肠癌的有效手段之一.展开更多
文摘Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.
文摘Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called 'trifecta'. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.
文摘Background: To investigate the learning curve of “robotic surgery” versus “conventional laparoscopy” in two trials of the FLS program in a population of medical students with no experience in laparoscopy. Methods: A prospective trial. Students, all novices in training and surgical practice, were randomized into 2 groups: the “traditional laparoscopy” group and the “robotic assistance” group. Students were evaluated during two tests from the FLS: peg transfer and intracorporeal knot tying. Results: The median laparoscopic knot completion time was significantly lower in the “robotic surgery” group (p = 0.038). Conclusions: Robotic assistance training in neophytes is effective in improving the completion time of laparoscopic knots.
文摘目的探究达芬奇机器人在直肠癌全直肠系膜切除术中的应用效果。方法研究对象为2022年1月—2023年1月福建医科大学肿瘤临床医学院/福建省肿瘤医院收治的96例直肠癌拟行手术治疗的患者,采用计算机法将患者以0.001~0.096编号,0.001~0.048编号的患者为对照组,0.049~0.096编号的患者为观察组,每组各48例。对照组患者接受腹腔镜下全直肠系膜切除术,观察组采用达芬奇机器人行全直肠系膜切除术,对比不同手术方式患者手术相关指标、恢复情况、肿瘤学情况以及术后并发症的发生情况。结果两组手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量低于对照组(P<0.05);两组引流管留置时间比较,差异无统计学意义(P>0.05),观察组术后排气时间、首次流质饮食时间、术后住院时间短于对照组(P<0.05),观察组住院费用高于对照组(P<0.05);两组术后肿瘤病理分型、分级、国际抗癌联盟/美国癌症联合会(UN Economic and Social Council/American Joint Committee on Cancer,UICC/AJCC)分期以及淋巴结清扫数比较,差异无统计学意义(P>0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论直肠癌全直肠系膜切除术中,达芬奇机器人与腹腔镜均有较为显著的治疗效果和安全性,而达芬奇机器人术中出血量更低,术后胃肠道功能恢复更快,缩短患者的住院时间。
文摘目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术(腹腔镜组).比较两组患者手术情况、术后恢复情况及术后并发症.结果:机器人组手术时间明显长于腹腔镜组(161.1 min±41.4 min vs 135.5 min±39.1m i n,P=0.001),术中出血量少于腹腔镜组(104.8 m L±70.8 m L vs 140.3 m L±81.4 m L,P=0.013),低位直肠癌的保肛率高于腹腔镜组[65.0%(13/20)vs 25.0%(4/16),P=0.017],排气时间、进流质时间、拔尿管时间均短于腹腔镜组(P<0.05),但住院费用明显高于腹腔镜组(2.7万元±1.1万元vs 4.3万元±1.3万元,P=0.000).两组手术均无中转开腹.两组在标本切除长度、肿瘤下缘距下切缘的长度、淋巴结清扫数目、术后住院时间和术后并发症发生率方面比较差异无统计意义(P>0.05).结论:达芬奇机器人直肠癌根治术取得与腹腔镜手术相同的根治效果,并具有创伤小、术中出血少、术后恢复快、保肛率高等优势,可作为治疗直肠癌的有效手段之一.