大辩论:急症护理中的机器人与传统手术方法。

Jessica Wu, Matthew J Martin, Vincent E Kirkpatrick, S. Cassaro, Ferdinand Pérez Rodríguez
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摘要

机器人手术最早出现于 20 世纪 80 年代,是一种在战场上帮助病人的系统。从那时起,机器人手术已成为一种重要的微创工具,并在各外科专科的择期手术中发挥着重要作用。然而,机器人手术在急诊环境中的作用还没有得到很好的确定或研究。机器人手术已被证明对患者和手术外科医生都有利。尽管数量有限,但研究发现在急诊环境中使用机器人手术对患者是安全的。这些研究发现,与开腹或腹腔镜方法相比,机器人手术的围手术期效果更好。此外,机器人平台被认为是一种有效的工具,可防止在紧急情况下转为开放手术。尽管一些研究表明机器人急症手术具有优势,但也有一些研究表明机器人急症手术的并发症会增加,或者机器人手术与腹腔镜手术相比没有明显优势。此外,一些发表的支持在急诊环境中使用机器人手术的论文可能在一定程度上偏向于机器人平台。机器人手术是微创择期手术的主流,越来越受到患者和外科医生的欢迎。在急诊环境中使用机器人平台有利有弊。要确定机器人平台在急诊环境中的真正作用,还需要进行更多的大规模研究。
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The Great Debate: Robotic vs Traditional Surgical Approach in the Acute Care Setting.
Robotic surgery was first introduced in the 1980s as a system to aid patients in the battlefield. Since then, robotic surgery has become an important minimally invasive tool and plays an important role in elective surgery among various surgical specialties. However, the role for robotic surgery in the emergent setting is not well established or studied. Robotic surgery has been shown to be advantageous to both patients and operating surgeons. Though limited, studies have found robotic surgery in the acute setting to be safe for patients. These studies found robotic surgery to have improved perioperative outcomes when compared to an open or laparoscopic approach. Additionally, the robotic platform is thought to be an effective tool to prevent conversion to open procedures in emergent settings. Although some studies demonstrate advantages to robotic acute surgery, others have shown increased complications with robotic acute surgery or no distinct advantage when comparing robotic to laparoscopic surgery. Additionally, some of the published papers supporting the use of robotic surgery in the emergent setting may have a degree of bias favoring the robotic platform. Robotic surgery is a mainstay in minimally invasive elective surgery and gaining popularity among patients and surgeons. There are pros and cons to the adaptation of the robotic platform in the acute care setting. Additional large population studies are indicated to determine the true role of the robotic platform in the emergent setting.
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