在远程机器人辅助腹腔镜根治性肾切除术中，第一助手发挥的作用远高于其他手术中的第一助手， 其职责不限于与主刀进行术中配合，更需要根据手术现场的情况组织协调手术团队开展工作。助手的工作贯穿整个 远程手术，第一助手应在术前常规访视患者，向患者以及家属介绍病情及手术过程，确保其充分知情；在手术开始 之前第一助手应根据术式及患者特点，个性化调整手术体位以及套管位置；术中根据手术现场情况积极与主刀沟通 交流，配合主刀完成关键手术步骤的相关操作；在面对突发不良事件时，第一助手应主动指挥、协调现场工作人员 积极排查故障来源，及时修复故障。本文总结了远程手术机器人辅助腹腔镜根治性肾切除术第一助手配合的经验要 点，以期不断优化远程手术。

In remote robot-assisted laparoscopic radical nephrectomy, the role of the first assistant is more important than that in other surgeries, whose duties are not limited to the intraoperative cooperation with the surgeon, but also required to organize and coordinate different work of the surgical team members according to the specific surgical site conditions. The work of assistant is carried out throughout the entire telesurgery. Firstly, the first assistant should routinely visit the patient before surgery, patient’s condition and surgical processes should be introduced to the patient and his/her family, and ensure that he/she is fully informed. Secondly, the first assistant should adjust surgical position and distributions of Trocars in line with specific surgical procedures and patient’s characteristics before surgery. Furthermore, the first assistant should communicate with the chief surgeon as required by the specific site conditions and assist him/her to complete the key surgical steps. More importantly, in the face of unexpected adverse events, the first assistant should take the initiative to command and coordinate on-site staff to actively investigate the source of the fault, and solve it in time. The key points of the first assistant’s experience in remote robot-assisted laparoscopic radical nephrectomy for renal cancer is summarized in this paper, with the purpose of optimizing telesurgery constantly.

收稿日期：2021-12-20  录用日期：2022-03-22 

Received Date: 2021-12-20  Accepted Date: 2022-03-22 

基金项目：山东省重大科技创新工程项目（2019JZZY021002）；山东省泰山学者资助项目（tsqn20161077） 

Foundation Item: Major Scientific and Technological Innovation Project of Shandong Province (2019JZZY021002); Taishan Scholar Program of Shandong Province (tsqn20161077) 

通讯作者：牛海涛，Email：niuht0532@126.com；杨学成，Email：m18661805062@163.com Corresponding Author: NIU Haitao,  Email:  niuht0532@126.com; YANG Xuecheng, Email: m18661805062@163.com 

引用格式：苑航，骆磊，焦伟，等 . 远程手术机器人辅助腹腔镜根治性肾切除术第一助手的配合 [J]. 机器人外科学杂志（中英文）， 2024，5（6）1221-1224. 

Citation: YUAN H,  LUO L,  JIAO W,  et al. First assistant in the cooperation work of remote robot-assisted laparoscopic radical nephrectomy for renal cancer[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1221-1224. 

注：苑航，骆磊为共同第一作者 

Co-first Author: YUAN Hang, LUO Lei

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