单点机器人胆囊切除术的现状、可行性、经济性和整体影响。

D. Vyas, Cara Weiner, A. Vyas
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引用次数: 5

摘要

本文综述了机器人单部位胆囊切除术(RSSC)这一在研究和临床应用中都迅速发展的相对较新的方法。腹腔镜检查通常是执行胆囊切除术的标准方法,但最近的医学进步已经导致使用达芬奇®手术系统机器人技术来协助执行程序。一些研究比较了RSSC与单孔腹腔镜胆囊切除术和传统的多孔腹腔镜胆囊切除术的结果。单一端口的支持者认为它是一种更好的美容效果和更少的术后疼痛的工具;然而,单端口也限制了器械臂的可操作性,使一些任务更加困难,单切口更大,术后疝气的可能性更大。总的来说,与其他胆囊切除术方法相比,RSSC被认为是安全的,在疼痛、住院时间、手术时间和患者满意度方面没有更差的结果。未来的方向包括扩大微型仪器和更先进的工具的使用,以克服操作和可视化的限制。然而,到目前为止,这些较小的研究可能有足够的证据支持更多地使用资源不会造成伤害。
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Current Status of Single-Site Robotic Cholecystectomy, its feasibility, economic and overall impact.
This paper reviews recent, though limited, articles on the topic of robotic single-site cholecystectomy (RSSC), a relatively new approach that is rapidly advancing in both research and clinical application. Laparoscopy has typically been the standard method of performing a cholecystectomy, but recent medical advances have led to usage of the da Vinci® Surgical System robot technology to assist in performing the procedure. Several studies have compared outcomes of the RSSC to single-port laparoscopic cholecystectomies and to the traditional multiport laparoscopic cholecystectomies. Single port advocates think it as a tool with better cosmetic results and questionable less post-operative pain; however, single port also limits the maneuverability of the instrument arms, making some tasks more difficult, bigger single incision, more chances of post operative hernia. Overall, the RSSC is considered as safe with no worse outcomes regarding pain, hospital stay length, operative time, and patient satisfaction when compared to other cholecystectomy methods. Future direction includes expanding use of the miniature instruments and further advanced tools to overcome manipulation and visualization limitations. Thus far, though, there may be enough evidence with these smaller studies to support lack of harm with more use of resources.
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