Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review art...Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.展开更多
目的:评价机器人辅助胸腔手术(Robot-assisted thoracic surgery,RATS)与传统胸腔镜手术(Video-assisted thoracic surgery,VATS)在肺癌淋巴结整块清扫中的临床疗效。方法:回顾性分析2017年5月~2019年12月在甘肃省人民医院接受达芬奇机...目的:评价机器人辅助胸腔手术(Robot-assisted thoracic surgery,RATS)与传统胸腔镜手术(Video-assisted thoracic surgery,VATS)在肺癌淋巴结整块清扫中的临床疗效。方法:回顾性分析2017年5月~2019年12月在甘肃省人民医院接受达芬奇机器人和胸腔镜进行淋巴结整块清扫手术的128例肺癌患者的临床资料,分别为RATS组与VATS组,其中接受RATS的患者56例,VATS 72例。结果:RATS组与VATS组相比,手术时间(171.31min Vs 154.26min,P=0.026)、术中失血量(62.29ml Vs 92.73ml,P=0.031)、术后引流时间(5.72d Vs 7.13d,P=0.043)、总引流量(1105.76ml Vs 1434.62ml,P=0.017)、术后住院时间(7.25d Vs 9.36d,P=0.003)、淋巴结清扫总数(17.38个Vs 12.93个,P=0.045)比较,差异具有统计学意义。而两组术后并发症比较,差异没有统计学意义(P>0.05)。但RATS组在进行左肺上叶手术时以及清扫2、4、7组淋巴结时比VATS组更具有显著优势,差异有统计学意义(P<0.05)。结论:机器人系统在肺癌根治术淋巴结清扫中,操作安全、创伤小,且在清扫胸部淋巴结时更加有效,更利于患者的术后恢复,能减少复发及转移的可能性,使患者切实获益。展开更多
BACKGROUND Secondary lymphedema after surgical interventions is a progressive,chronic disease that is still not completely curable.Over the past years,a multitude of surgical therapy options have been described.AIM To...BACKGROUND Secondary lymphedema after surgical interventions is a progressive,chronic disease that is still not completely curable.Over the past years,a multitude of surgical therapy options have been described.AIM To summarize the single-center complications in lymph vessel(LVTx)and free vascularized lymph node transfer(VLNT).METHODS In total,the patient collective consisted of 87 patients who were undergoing treatment for secondary leg lymphedema during the study period from March 2010 to April 2020.The data collection was performed preoperatively during consultations,as well as three weeks,six months and twelve months after surgical treatment.In the event of complications,more detailed follow-up checks were carried out.In total n=18 robot-assisted omental lymph node transplantations,n=33 supraclavicular lymph node transplantations and n=36 Lymph vessel transplantations were analyzed.An exemplary drawing is shown in Figure 1.A graphical representation of patient selection is shown in Figure 2.Robotic harvest was performed with the Da Vinci Xi Robot Systems(Intuitive Surgical,CA,United States).RESULTS In total,11 male and 76 female patients were operated on.The mean age of the patients at study entry was:omental VLNT:57.45±8.02 years;supraclavicular VLNT:49.76±4.16 years and LVTx:49.75±4.95 years.The average observation time postoperative was:omental VLNT:18±3.48 mo;supraclavicular VLNT:14.15±4.9 and LVTx:14.84±4.46 mo.In our omental VLNT,three patients showed a slight abdominal sensation of tension within the first 12 postoperative days.No other donor side morbidities occurred.No intraoperative conversion to open technique was needed.Our supraclavicular VLNT collective showed 10 lift defect morbidities with one necessary surgical intervention.In our LVTx collective,12 cases of donor side morbidity were registered.In one case,surgical intervention was necessary.CONCLUSION Concerning donor side morbidity,robot-assisted omental VLNT is clearly superior to supraclavicular lymph node transplantation and LVTx.展开更多
目的评估机器人(达芬奇系统)辅助胸腔镜解剖性肺切除手术的有效性、安全性及可行性,总结机器人手术的学习曲线。方法回顾性分析2016年3~6月,我科机器人辅助胸腔镜解剖性肺切除手术40例患者的临床资料,男29例、女11例,年龄54~78(60.2...目的评估机器人(达芬奇系统)辅助胸腔镜解剖性肺切除手术的有效性、安全性及可行性,总结机器人手术的学习曲线。方法回顾性分析2016年3~6月,我科机器人辅助胸腔镜解剖性肺切除手术40例患者的临床资料,男29例、女11例,年龄54~78(60.2±12.7)岁;与同期行常规胸腔镜手术的37例患者[男27例、女10例,年龄52~76(58.7±11.5)岁]进行对比,分析其手术时间、术中出血量、胸腔引流时间、术后住院时间、围手术期并发症发生率及死亡率,评估其安全性及可行性,同时总结机器人手术的学习曲线。结果两组患者手术时间、术后呼吸机辅助时间、术中出血量、胸腔引流时间和术后疼痛,术后平均住院日,术后并发症发生率差异均无统计学意义。机器人辅助组术前准备时间长于胸腔镜组(24.5 min vs.15.6 min,P=0.003),机器人辅助组术中中转率低于胸腔镜组(0 vs.10.8%),两组均无围手术期死亡。结论机器人辅助胸腔镜解剖性肺切除手术在前期学习过程中安全有效,初始10例手术过后,学习曲线即可从学习阶段进入到标准阶段。展开更多
文摘Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.
文摘目的:评价机器人辅助胸腔手术(Robot-assisted thoracic surgery,RATS)与传统胸腔镜手术(Video-assisted thoracic surgery,VATS)在肺癌淋巴结整块清扫中的临床疗效。方法:回顾性分析2017年5月~2019年12月在甘肃省人民医院接受达芬奇机器人和胸腔镜进行淋巴结整块清扫手术的128例肺癌患者的临床资料,分别为RATS组与VATS组,其中接受RATS的患者56例,VATS 72例。结果:RATS组与VATS组相比,手术时间(171.31min Vs 154.26min,P=0.026)、术中失血量(62.29ml Vs 92.73ml,P=0.031)、术后引流时间(5.72d Vs 7.13d,P=0.043)、总引流量(1105.76ml Vs 1434.62ml,P=0.017)、术后住院时间(7.25d Vs 9.36d,P=0.003)、淋巴结清扫总数(17.38个Vs 12.93个,P=0.045)比较,差异具有统计学意义。而两组术后并发症比较,差异没有统计学意义(P>0.05)。但RATS组在进行左肺上叶手术时以及清扫2、4、7组淋巴结时比VATS组更具有显著优势,差异有统计学意义(P<0.05)。结论:机器人系统在肺癌根治术淋巴结清扫中,操作安全、创伤小,且在清扫胸部淋巴结时更加有效,更利于患者的术后恢复,能减少复发及转移的可能性,使患者切实获益。
文摘BACKGROUND Secondary lymphedema after surgical interventions is a progressive,chronic disease that is still not completely curable.Over the past years,a multitude of surgical therapy options have been described.AIM To summarize the single-center complications in lymph vessel(LVTx)and free vascularized lymph node transfer(VLNT).METHODS In total,the patient collective consisted of 87 patients who were undergoing treatment for secondary leg lymphedema during the study period from March 2010 to April 2020.The data collection was performed preoperatively during consultations,as well as three weeks,six months and twelve months after surgical treatment.In the event of complications,more detailed follow-up checks were carried out.In total n=18 robot-assisted omental lymph node transplantations,n=33 supraclavicular lymph node transplantations and n=36 Lymph vessel transplantations were analyzed.An exemplary drawing is shown in Figure 1.A graphical representation of patient selection is shown in Figure 2.Robotic harvest was performed with the Da Vinci Xi Robot Systems(Intuitive Surgical,CA,United States).RESULTS In total,11 male and 76 female patients were operated on.The mean age of the patients at study entry was:omental VLNT:57.45±8.02 years;supraclavicular VLNT:49.76±4.16 years and LVTx:49.75±4.95 years.The average observation time postoperative was:omental VLNT:18±3.48 mo;supraclavicular VLNT:14.15±4.9 and LVTx:14.84±4.46 mo.In our omental VLNT,three patients showed a slight abdominal sensation of tension within the first 12 postoperative days.No other donor side morbidities occurred.No intraoperative conversion to open technique was needed.Our supraclavicular VLNT collective showed 10 lift defect morbidities with one necessary surgical intervention.In our LVTx collective,12 cases of donor side morbidity were registered.In one case,surgical intervention was necessary.CONCLUSION Concerning donor side morbidity,robot-assisted omental VLNT is clearly superior to supraclavicular lymph node transplantation and LVTx.
文摘目的评估机器人(达芬奇系统)辅助胸腔镜解剖性肺切除手术的有效性、安全性及可行性,总结机器人手术的学习曲线。方法回顾性分析2016年3~6月,我科机器人辅助胸腔镜解剖性肺切除手术40例患者的临床资料,男29例、女11例,年龄54~78(60.2±12.7)岁;与同期行常规胸腔镜手术的37例患者[男27例、女10例,年龄52~76(58.7±11.5)岁]进行对比,分析其手术时间、术中出血量、胸腔引流时间、术后住院时间、围手术期并发症发生率及死亡率,评估其安全性及可行性,同时总结机器人手术的学习曲线。结果两组患者手术时间、术后呼吸机辅助时间、术中出血量、胸腔引流时间和术后疼痛,术后平均住院日,术后并发症发生率差异均无统计学意义。机器人辅助组术前准备时间长于胸腔镜组(24.5 min vs.15.6 min,P=0.003),机器人辅助组术中中转率低于胸腔镜组(0 vs.10.8%),两组均无围手术期死亡。结论机器人辅助胸腔镜解剖性肺切除手术在前期学习过程中安全有效,初始10例手术过后,学习曲线即可从学习阶段进入到标准阶段。
