机器人手术自 21 世纪问世以来已成为微创手术的代表,并得到迅速发展。肝胆胰手术难度大,往往 涉及复杂的解剖、消化道重建及精细的血管吻合,这导致其微创手术的发展相对缓慢,而机器人手术则可打破这一 局面。如何拓宽机器人手术的适应证并进一步发展机器人手术技术则是未来外科发展的重要方向。本综述针对机器 人手术在肝胆胰外科中的应用现状及未来发展前景进行总结及展望。
Robotic surgery has become a representative of minimally invasive surgery and developed rapidly since its emergence in the 21st century. For hepatobiliary and pancreatic surgery, the development of minimally invasive surgery is relatively slow due to its difficulty to perform, which often involves complex anatomy, reconstruction of digestive tract and fine vascular anastomosis. However, robotic surgical system breaks this situation. How to expand the indications of robotic surgery and develop robotic technology in surgery is an important direction for the future development of surgery. In this paper, the application status and future development of robotic hepatobiliary and pancreatic surgery were discussed.
收稿日期:2021-06-10 录用日期:2022-01-17
Received Date: 2021-06-10 Accepted Date: 2022-01-17
基金项目:上海交通大学“交大之星”计划医工交叉研究基金(YG2019QNB26);上海理工大学医工交叉创新中心项目(1020308402)
Foundation Item: Interdisciplinary Program of Shanghai Jiao Tong University(YG2019QNB26); Program of Medical-Engineering Interdisciplinary Innovation Center of University of Shanghai for Science and Technology(1020308402)
通讯作者:彭承宏,Email:chhpeng@188.com
Corresponding Author: PENG Chenghong, Email: chhpeng@188.com
引用格式:钱剑锋,秦凯,金佳斌,等 . 机器人手术在肝胆胰外科中的应用与进展 [J]. 机器人外科学杂志(中英文),2023,4(1): 12-17.
Citation: QIAN J F, QIN K, JIN J B, et al. Application and progress of robotic hepatobiliary and pancreatic surgery [J]. Chinese Journal of Robotic Surgery, 2023, 4(1): 12-17.
[1] Giulianotti P C, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital[J]. Arch Surg, 2003, 138(7): 777-784.
[2] Liu R, Wakabayashi G, Kim H, et al. International consensus statement on robotic hepatectomy surgery in 2018[J]. World J Gastroenterol, 2019, 25(12): 1432-1444.
[3] Nota C L, Woo Y, Raoof M, et al. Robotic versus open minor liver resections of the posterosuperior segments: a multinational, propensity score-matched study[J]. Ann Surg Oncology, 2019, 26(2): 583-590.
[4] Machairas N, Papaconstantinou D, Tsilimigras D I, et al. Comparison between robotic and open liver resection: a systematic review and meta-analysis of short-term outcomes[J]. Updates Surg, 2019, 71(1): 39-48.
[5] Melstrom L G, Warner S G, Woo Y, et al. Selecting incision-dominant cases for robotic liver resection: towards outpatient hepatectomy with rapid recovery[J]. Hepatobiliary Surg Nutr, 2018, 7(2): 77-84.
[6] CHEN P D, WU C Y, HU R H, et al. Robotic versus open hepatectomy for hepatocellular carcinoma: a matched comparison[J]. Ann Surg Oncol, 2017, 24(4): 1021-1028.
[7] Berber E, Akyildiz H Y, Aucejo F, et al. Robotic versus laparoscopic resection of liver tumours[J]. HPB(Oxford), 2010, 12(8): 583-586.
[8] Ziogas I A, Giannis D, Esagian S M, et al. Laparoscopic versus robotic major hepatectomy: a systematic review and meta-analysis[J]. Surg Endosc, 2021, 35(2): 524-535.
[9] Han J H, Lee J H, Hwang D W, et al. Robot resection of a choledochal cyst with Roux-en-y hepaticojejunostomy in adults: initial experiences with 22 cases and a comparison with laparoscopic approaches[J]. Ann hepatobiliary Pancreat Surgery, 2018, 22(4): 359-366.
[10] Efanov M, Alikhanov R, Tsvirkun V, et al. Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection[J]. HPB(Oxford), 2017, 19(9): 818-824. [11] Zureikat A H, Moser A J, Boone B A, et al. 250 robotic pancreatic resections: safety and feasibility[J]. Ann Surg, 2013, 258(4): 554-562.
[12] Xourafas D, Ashley S W, Clancy T E. Comparison of perioperative outcomes between open, laparoscopic, and robotic distal pancreatectomy: an analysis of 1815 patients from the ACS-NSQIP procedure-targeted pancreatectomy database[J]. J Gastrointest Surg, 2017, 21(9): 1442-1452.
[13] Boone B A, Zenati M, Hogg M E, et al. Assessment of quality outcomes for robotic pancreaticoduodenectomy: identification of the learning curve[J]. JAMA Surg, 2015, 150(5): 416-422.
[14] SHI Y, WANG W, QIU W, et al. Learning curve from 450 cases of robot-assisted pancreaticoduocectomy in a high-volume pancreatic center: optimization of operative procedure and a retrospective study[J]. Ann Surg, 2019.
DOI: 10.1097/SLA.0000000000003664.
[15] SHI Y, JIN J, QIU W, et al. Short-term outcomes after robot-assisted vs open pancreaticoduodenectomy after the learning curve[J]. JAMA Surg, 2020, 155(5): 389-394.
[16] Liu R, Wakabayashi G, Palanivelu C, et al. International consensus statement on robotic pancreatic surgery[J]. Hepatobiliary Surg Nutr, 2019, 8(4): 345-360.
[17] SHI Y S, JIN J B, HUO Z, et al. An 8-year single-center study: 170 cases of middle pancreatectomy, including 110 cases of robot-assisted middle pancreatectomy[J]. Surgery, 2020, 167(2): 436-441.
[18] Nassour I, Tohme S, Hoehn R, et al. Safety and oncologic efficacy of robotic compared to open pancreaticoduodenectomy after neoadjuvant chemotherapy for pancreatic cancer[J]. Surg Endosc, 2021, 35(5): 2248-2254.
[19] Kauffmann E F, Napoli N, Menonna F, et al. Robotic pancreatoduodenectomy with vascular resection[J]. Langenbecks Arch Surg, 2016, 401(8): 1111-1122.
[20] Himpens J, Leman G, Cadiere G B. Telesurgical laparoscopic cholecystectomy[J]. Surg Endosc, 1998, 12(8): 1091.
[21] Magge D, Steve J, Novak S, et al. Performing the difficult cholecystectomy using combined endoscopic and robotic techniques: how I do it[J]. J Gastrointest Surg, 2017, 21(3): 583-589.
[22] Giulianotti P C, Quadri P, Durgam S, et al. Reconstruction/repair of latrogenic biliary injuries: is the robot offering a new option? Short clinical report[J]. Annals of Surgery, 2018, 267(1): e7-e9.
[23] Chang K, Gokcal F, Kudsi O Y. Robotic biliary surgery[J]. Surg Clin North Am, 2020, 100(2): 283-302.
[24] 刘永强 , 王伯胜 , 郭玉林 , 等 . Ⅲ、Ⅳ型肝门胆管 癌的治疗现状 [J]. 中国现代普通外科进展 , 2020, 23(2): 164-168.
[25] LI J, TAN X, ZHANG X, et al. Robotic radical surgery for hilar cholangiocarcinoma: a single-centre case series[J]. Int J Med Robot, 2020, 16(2): e2076.