机器人胃癌手术中第一助手的作用不可或缺，甚至能决定手术的成败。助手的工作应从术前准备开始，包括与患者、术者、手术室护士的沟通，体位的选择，切口的位置及穿刺器（Trocar）的布局，机械臂的调整及助手站位的选择；术中配合术者悬吊肝脏，牵拉暴露止血，以及消化道重建等；术后对于每一台手术进行及时总结并改进，与术者及时交流才能在手术中快速提高自身技能，配合术者流畅完成一台机器人胃癌手术。

The first assistant is indispensable to robot-assisted radical gastrectomy for gastric cancer, even can determine the success or failure of the surgery. The main work of the first assistant includes communicating with patients, chief surgeon and nurses of operating room on patient positioning, incision and Trocar location, adjustment of mechanical arm, and determination of assistants’ positions. The first assistant shall also help the chief surgeon suspend liver, pull exposed tissue to stop bleeding and reconstruct digestive tract reconstruction during operation. It is important for the first assistant to communicate with the chief surgeon and other team members after surgery and summarize the experience of each surgery, which can help him improve his proficiency and cooperate with the chief surgeon well to complete next robot-assisted radical gastrectomy for gastric cancer.

收稿日期：2021-01-07  录用日期：2021-03-21

Received Date: 2021-01-07  Accepted Date: 2021-03-21

通讯作者：赵群，Email：zhaoqun@hebmu.edu.cn

Corresponding Author: ZHAO Qun, Email: zhaoqun@hebmu.edu.cn

引用格式：田园，李勇，林叶成，等 . 机器人辅助下胃癌手术第一助手的配合 [J]. 机器人外科学杂志（中英文），2021，2（5）：382-386.

Citation: TIAN Y, LI Y, LIN Y C, et al. Cooperation work of the first assistant in robot-assisted radical gastrectomy for gastric cancer [J]. Chinese Journal of Robotic Surgery, 2021, 2(5):382-386.

[1] Kim H I, Han S U, Yang H K, et al. Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma[J]. Ann Surg, 2016, 263(1): 103-109.

[2] SHEN W, X I H, WEI B, et al. Robotic versus laparoscopic gastrectomy for gastric cancer: comparison of short-term surgical outcomes[J]. Surg Endosc, 2016,30(2): 574-580.

[3] 中国研究型医院学会机器人与腹腔镜外科专业委员会 . 机器人胃癌手术专家共识 (2015 版 )[J]. 中华消化外科杂志 , 2016, 15(1): 7-11.

[4] Van’t Hullenaar C D P, Bos P, Broeders I A M J. Ergonomic assessment of the first assistant during robotassisted surgery[J]. J Robot Surg, 2019, 13(2): 283-288.

[5] 吴硕东 , 姚殿波 , 孙余田 . 肝左外叶粘贴式悬吊在单孔腹腔镜左季肋区手术中的应用价值 [J]. 中华消化外科杂志 , 2018, 17(5): 497-501.

[6] 计勇 , 余思 , 杨平 , 等 . 一种新的肝脏悬吊方式在腹腔镜胃癌根治术中的应用 [J]. 中华胃肠外科杂志 , 2018, 21(8): 917.

[7] 王博方 , 马臻 , 汪学艳 , 等 . 腹腔镜下肝脏悬吊方法进展 [J]. 中华普通外科杂志 , 2020, 35(2): 171-173.

[8] 黄庆波 , 艾青 , 倪栋 , 等 . 如何成为一名合格的泌尿外科机器人手术助手 [J]. 微创泌尿外科杂志 , 2017,6(4): 193-197.

[9] 秦倩 , 时飞宇 , 孙祺 , 等 . 达芬奇机器人手术系统辅助胃癌根治术的学习曲线 [J].中华消化外科杂志 ,2019, 18(5): 459-465.

[10] 刘东宁 , 何鹏辉 , 熊强强 , 等 . 机器人远端胃癌根治术的学习曲线 [J]. 中华腔镜外科杂志 ( 电子版 ),2016, 9(6): 335-338.

[11] 陈鹏 , 李瑞 , 董玲 , 等 . 达芬奇机器人胃癌根治术的近期可行性和安全性分析 [J]. 中国普通外科杂志 , 201, 27 (10): 1304-1311.

[12] 王沛云 , 熊兵红 , 曾玉剑 , 等 . 达芬奇机器人与腹腔镜手术治疗胃癌疗效比较的 Meta 分析 [J]. 中国普通外科杂志 , 2017, 26(4): 412-424.

[13] 吉国锋 , 陶有茂 , 张涛 , 等 . 机器人与腹腔镜手术治疗胃癌的近期疗效对比 Meta 分析 [J]. 中国普通外科杂志 , 2015, 24(4): 538-546.