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Current status of robot-assisted gastric surgery

机译:机器人辅助胃手术的现状

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摘要

In an effort to minimize the limitations of laparoscopy, a robotic surgery system was introduced, but its role for gastric cancer is still unclear. The objective of this article is to assess the current status of robotic surgery for gastric cancer and to predict future prospects. Although the current study was limited by its small number of patients and retrospective nature, robot-assisted gastrectomy with lymphadenectomy for the treatment of gastric cancer is a feasible and safe procedure for experienced laparoscopic surgeons. Most studies have reported satisfactory results for postoperative short-term coutcomes, such as: postoperative oral feeding, gas out, hospital stay and complications, compared with laparoscopic surgery; the difference is a longer operation time. However, robotic surgery showed a shallow learning curve compared with the familarity of conventional open surgery; after the accumulation of several cases, robotic surgery could be expected to result in a similar operation time. Robotic-assisted gastrectomy can expand the indications of minimally invasive surgery to include advanced gastric cancer by improving the ability to perform lymphadenectomy. Moreover, ”total” robotic gastrectomy can be facilitated using a robot-sewing technique and gastric submucosal tumors near the gastroesophageal junction or pylorus can be resected safely by this novel technique. In conclusion, robot-assisted gastrectomy may offer a good alternative to conventional open or laparoscopic surgery for gastric cancer, provided that long-term oncologic outcomes can be confirmed.
机译:为了尽量减少腹腔镜检查的局限性,引入了机器人手术系统,但是其在胃癌中的作用仍不清楚。本文的目的是评估胃癌机器人手术的现状,并预测未来的前景。尽管当前的研究受到患者人数少和回顾性的限制,但是对于有经验的腹腔镜外科医生来说,机器人辅助胃切除术与淋巴结清扫术治疗胃癌是一种可行且安全的方法。大多数研究都报告了术后短期结果令人满意的结果,例如:与腹腔镜手术相比,术后口服喂食,出气,住院和并发症。区别在于操作时间更长。然而,与传统的开放式手术相比,机器人手术的学习曲线较浅。在累积了好几例病例之后,机器人手术有望带来相似的手术时间。机器人辅助胃切除术可通过提高执行淋巴结切除术的能力,将微创手术的适应症扩展至晚期胃癌。此外,可以使用机器人缝合技术来促进“全部”机器人胃切除术,并且通过这种新技术可以安全地切除胃食管连接处或幽门附近的胃粘膜下肿瘤。总之,如果可以确认长期的肿瘤学结局,机器人辅助胃切除术可以替代传统的开放式或腹腔镜胃癌手术。

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