随着科技的进步及制造业水平的提升,医用机器人的发明可谓 20 世纪末人类在医学技术装备领域取 得的重大突破之一。医用机器人的典型代表为达芬奇手术机器人,其为精准微创外科的发展奠定了坚实的基础,机 器人辅助胸外科手术(RATS)是未来胸部微创外科的发展方向之一。目前达芬奇手术机器人在各医疗中心应用日益 广泛,掌握手术机器人技术将成为未来胸外科医生必备的技能之一。本研究就达芬奇机器人辅助胸腔镜手术在肺癌 治疗中的应用及进展做一综述。
With the advances of science and technology and the improvement of manufacturing level, medical robots were invented and had been one of the major breakthroughs in the field of armarium at the end of the 20th century. The typical representative of medical robots is Da Vinci robotic surgical system, which has laid a solid foundation for the development of precision medicine and minimally invasive surgery. Meanwhile, robot-assisted thoracic surgery (RATS) has been one of the future directions of minimally invasive thoracic surgery. Da Vinci robot is now being increasingly used in various medical centers, and mastery of robotic technology will become one of the necessary skills for future thoracic surgeons. The application and progress of Da Vinci robot-assisted thoracoscopic surgery in the treatment of lung cancer is reviewed in this paper.
收稿日期:2024-03-05 录用日期:2024-04-16
Received Date: 2024-03-05 Accepted Date: 2024-04-16
基金项目:省部共建中亚高发病成因与防治国家重点实验室开放课题基金(SKL-HIDCA-2020-13);自治区区域协同创新专项(科 技援疆计划)(2024E02061)
Foundation Item: Open Subject Fund of State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia (SKL-HIDCA-2020-13) ; Special Project for Collaborative Innovation of Xinjiang Uygur Autonomous Region (Science and Technology Supporting Plan to Xinjiang Uygur Autonomous Region)(2024E02061)
通讯作者:罗洞波,Email: 13999891258@139.com
Corresponding Author: LUO Dongbo, Email: 13999891258@139.com
引用格式:陈军,罗洞波 . 达芬奇手术机器人在肺癌治疗中的应用进展(附手术视频)[J]. 机器人外科学杂志(中英文),2024, 5(5):991-1000.
Citation: CHEN J, LUO D B. Application progress of Da Vinci surgical robot in the treatment of lung cance(with surgical video)[J]. Chinese Journal of Robotic Surgery, 2024, 5( 5): 991-1000.
[1] Melfi F M A, Menconi G F, Mariani A M, et al. Early experience with robotic technology for thoracoscopic surgery[J]. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
[2] LIN M W, KUO S W, YANG S M, et al. Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer[J]. J Thorac Dis, 2016, 8(7): 1747-1752.
[3] 张斯渊 , 董信春 , 苟云久 , 等 . 达芬奇机器人辅助支气管袖式肺 叶切除术的围术期疗效和安全性分析 [J]. 中国胸心血管外科临 床杂志 , 2020, 27(10): 1145-1149.
[4] JIAO W J, ZHAO Y D, QIU T, et al. robotic bronchial sleeve lobectomy for central lung tumors: technique and outcome[J]. The Annals of thoracic surgery, 2019, 108(1): 211-218.
[5] HAN Y, ZHANG Y J, LI C Q, et al. Robotic lung cancer surgery: from simple to complex, from surgery to clinical study[J]. Journal of thoracic disease, 2020, 12(2): 51-53.
[6] Pardolesi A, Veronesi G, Solli P, et al. Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy[J]. J Thorac Cardiovasc Surg, 2014, 148(2): 737-738.
[7] Cerfolio R, Louie B E, Farivar A S, et al. Consensus statement on definitions and nomenclature for robotic thoracic surgery[J]. The Journal of Thoracic and Cardiovascular Surgery, 2017, 154(3): 1065- 1069.
[8] 罗清泉 , 王述民 , 李鹤成 , 等 . 机器人辅助肺癌手术中国临床专 家共识 [J]. 中国胸心血管外科临床杂志 , 2020, 27(10): 1119-1126.
[9] Ninan M, Dylewski M R. Total port-access robot-assisted pulmonary lobectomy without utility thoracotomy[J]. Eur J Cardiothorac Surg, 2010, 38(2): 231-232.
[10] Veronesi G, Agoglia B G, Melfi F, et al. Experience with robotic lobectomy for lung cancer[J]. Innovations (Phila), 2011, 6(6): 355-360.
[11] 张连民 , 赵晓亮 , 徐峰 , 等 . 全孔道 (port-only) 人工气胸下机器 人辅助肺叶切除术 [J]. 中国肺癌杂志 , 2020, 23(1): 50-54.
[12] Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer[J]. J Thorac Cardiovasc Surg, 2010, 140(1): 19-25.
[13] Park B J, Flores R M, Rusch V W. Robotic assistance for videoassisted thoracic surgical lobectomy: technique and initial results[J]. J Thorac Cardiovasc Surg, 2006, 131(1): 54-59.
[14] Parini S, Massera F, Papalia E, et al. Port placement strategies for robotic pulmonary lobectomy: a narrative review[J]. Journal of clinical medicine, 2022, 11(9): 2612.
[15] 李重武 , 黄佳 , 李剑涛 , 等 . 连续 1000 例机器人辅助胸腔镜 肺部手术回顾性分析 [J]. 中国胸心血管外科临床杂志 , 2019, 26(1): 42-47.
[16] 孟浩 , 王希龙 , 许世广 , 等 . 达芬奇机器人手术系统胸外科手 术切口选择 : 661 例手术经验分析 [J]. 临床军医杂志 , 2016, 44(06): 556-562.
[17] 许世广 , 王述民 . 做好达芬奇机器人肺叶切除手术前的准备 工作——一个助手的经验分享 [J]. 实用医院临床杂志 , 2015, 12(01): 35-38.
[18] YANG N, HE X Y, BAI Q Z, et al. Analysis of the short-term outcomes of biportal robot-assisted lobectomy[J]. The international journal of medical robotics and computer assisted surgery, 2021, 17(6): e2326.
[19] Gonzalez-Rivas D, Manolache V, Bosinceanu M L, et al. Uniportal pure robotic-assisted thoracic surgery-technical aspects, tips and tricks[J]. Ann Transl Med, 2023, 11(10): 362.
[20] Cerfolio R J, Watson C, Minnich D J, et al. One hundred planned robotic segmentectomies: early results, technical details, and preferred port placement[J]. The Annals of thoracic surgery, 2016, 101(3): 1089-1096.
[21] Cerfolio R J. Total port approach for robotic lobectomy[J]. Thoracic surgery clinics, 2014, 24(2): 151-156.
[22] Khan N, Fikfak V, Chan E Y, et al. “Five on a Dice” port placement allows for successful robot-assisted left pneumonectomy[J]. Thorac Cardiovasc Surg Rep, 2017, 6(1): e42-e44.
[23] Kim M P, Chan E Y. “Five on a dice” port placement for robotassisted thoracoscopic right upper lobectomy using robotic stapler[J]. Journal of thoracic disease, 2017, 9(12): 5355-5362.
[24] Oh D S, Tisol W B, Cesnik L, et al. Port Strategies for robot-assisted lobectomy by high-volume thoracic surgeons: a nationwide survey[J]. Innovations (Phila), 2019, 14(6): 545-552.
[25] Sung H, Ferlay J, Siegel R L, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: a cancer journal for clinicians, 2021, 71(3): 209-249.
[26] 董懂 , 黄意恒 , 张亚杰 , 等 . 《中华医学会肺癌临床诊疗指南 (2023 版 )》解读 [J]. 中国胸心血管外科临床杂志 , 2023, 30(11): 1533-1538.
[27] 胡坚 , 陈军 , 陈昶 , 等 . 肺部结节 ( ≤ 2 cm) 楔形切除胸外科全 国专家共识 (2023 版 )[J]. 中国肺癌杂志 , 2023, 26(05): 338-347.
[28] ZHAO X J, QIAN L Q, LIN H, et al. Robot-assisted lobectomy for non-small cell lung cancer in china: initial experience and techniques[J]. Journal of thoracic disease, 2010, 2(1): 26-28.
[29] Kent M S, Hartwig M G, Vallieres E, et al. Pulmonary open, robotic, and thoracoscopic lobectomy (portal) study: an analysis of 5721 cases[J]. Ann Surg, 2023, 277(3): 528-533.
[30] Kent M S, Hartwig M G, Vallières E, et al. Pulmonary open, robotic, and thoracoscopic lobectomy (portal) study: survival analysis of 6646 cases[J]. Ann Surg, 2023, 277(6): 1002.
[31] JIN R, ZHENG Y Y, YUAN Y, et al. Robotic-assisted versus videoassisted thoracoscopic lobectomy: short-term results of a randomized clinical trial (RVlob Trial)[J]. Ann Surg, 2022, 275(2): 295.
[32] Patel Y S, Baste J M, Shargall Y, et al. Robotic lobectomy is costeffective and provides comparable health utility scores to videoassisted lobectomy: early results of the raval trial[J]. Ann Surg, 2023, 278(6): 841-849.
[33] Ginsberg R J, Rubinstein L V. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group[J]. Ann Thorac Surg, 1995, 60(3): 615-622.
[34] Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/ WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial[J]. The Lancet (British edition), 2022, 399(10335): 1607-1617.
[35] Altorki N, Wang X, Kozono D, et al. Lobar or Sublobar resection for peripheral stage ia non-small-cell lung cancer[J]. The New England journal of medicine, 2023, 388(6): 489-498.
[36] ZHANG Y J, CHEN C, HU J, et al. Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: a multi-institutional propensity score-matched analysis[J]. J Thorac Cardiovasc Surg, 2020, 160(5): 1363-1372.
[37] Caso R, Watson T J, Tefera E, et al. Comparing robotic, thoracoscopic, and open segmentectomy: a national cancer database analysis[J]. Journal of surgical research, 2024, 296: 674-680.
[38] YANG M Z, TAN Z H, LI J B, et al. Comparison of short-term outcomes between robot-assisted and video-assisted segmentectomy for small pulmonary nodules: a propensity score-matching study[J]. Ann Surg Oncol, 2023, 30(5): 2757-2764.
[39] Geraci T C, Ferrari-Light D, Kent A, et al. Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy[J]. Ann Thorac Surg, 2019, 108(2): 363-369.
[40] Schmid T M, Augustin F M, Kainz G M, et al. Hybrid video-assisted thoracic surgery-robotic minimally invasive right upper lobe sleeve lobectomy[J]. Ann Thorac Surg, 2011, 91(6): 1961-1965.
[41] QIU T, ZHAO Y, XUAN Y P, et al. Robotic sleeve lobectomy for centrally located non-small cell lung cancer: a propensity scoreweighted comparison with thoracoscopic and open surgery[J]. J Thorac Cardiovasc Surg, 2020, 160(3): 838-846.
[42] JIN D C, DAI Q, HAN S C, et al. Effect of Da Vinci robot-assisted versus traditional thoracoscopic bronchial sleeve lobectomy[J]. Asian J. Surg, 2023, 46(10): 4191-4195.
[43] LIU A, ZHAO Y D, QIU T, et al. The long-term oncologic outcomes of robot-assisted bronchial single sleeve lobectomy for 104 consecutive patients with centrally located non-small cell lung cancer[J]. Transl Lung Cancer Res, 2022, 11(5): 869-879.
[44] QU J C, ZHANG W T, JIANG L. Two-port robotic sleeve lobectomy using Stratafix sutures for central lung tumors[J]. Thorac Cancer, 2022, 13(10): 1457-1462.
[45] Gonzalez-Rivas D, Bosinceanu M, Manolache V, et al. Uniportal fully robotic-assisted sleeve resections: surgical technique and initial experience of 30 cases[J]. Ann Cardiothorac Surg, 2023, 12(1): 9-22.
[46] YANG Y H, SONG L W, HUANG J, et al. A uniportal right upper lobectomy by three-arm robotic-assisted thoracoscopic surgery using the Da Vinci (Xi) Surgical System in the treatment of early-stage lung cancer[J].Transl Lung Cancer Res, 2021, 10(3): 1571-1575.
[47] Gonzalez-Rivas D, Bale M, Bosinceanu M L, et al. Uniportal robotic-assisted thoracoscopic surgery right upper lobectomy for aspergilloma[J]. Ann Cardiothorac Surg, 2023, 12(2): 142-143.
[48] Motas N, Manolache V, Bosinceanu M L, et al. Uniportal roboticassisted thoracic surgery anatomic segmentectomies[J]. Ann Cardiothorac Surg, 2023, 12(2): 133-135.
[49] Gonzalez-Rivas D, Koziej P H, Sediqi S, et al. Uniportal hybrid robotic-assisted right upper sleeve lobectomy in an 83-yearold patient with severe pulmonary hypertension[J]. Annals of cardiothoracic surgery, 2023, 12(2): 136-138.
[50] Gonzalez-Rivas D, Essa R A, Motas N, et al. Uniportal roboticassisted thoracic surgery lung-sparing carinal sleeve resection and reconstruction[J]. Ann Cardiothorac Surg, 2023, 12(2): 130-132.
[51] Gonzalez-Rivas D, Bosinceanu M, Manolache V, et al. Uniportal fully robotic-assisted bronchovascular sleeve bilobectomy[J]. Annals of cardiothoracic surgery, 2023, 12(2): 144-146.