Single-port robotic surgery: the next generation of minimally invasive urology
Single-port robotic surgery: the next generation of minimally invasive urology
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DOI：
10.1007/s00345-019-02898-1
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发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Crivellaro, Simone
中科院分区：
文献类型：
--
作者：
Dobbs, Ryan W.;Halgrimson, Whitney R.;Crivellaro, Simone
引言
达芬奇单孔（SP）手术平台（直观外科手术公司，加利福尼亚州森尼韦尔市）是近期获批的机器人手术平台，它相较于之前已有的单套管针模型有多处新颖的改进，包括可弯曲的摄像头、关节式器械以及用于器械位置实时监测的导航引导。我们试图描述我们使用该设备的临床经验，并回顾与SP平台使用相关的现有文献。
方法
我们对泌尿学领域内与单孔机器人手术相关的临床数据进行了叙述性综述。此外，我们报告了2018年12月至2019年4月在我们机构安装该系统后，使用SP平台进行手术操作的初步临床经验。
结果
目前，现有的单孔机器人泌尿外科手术文献由单中心病例报告和病例系列组成。使用达芬奇SP平台进行大多数主要的机器人泌尿外科手术在技术上似乎是可行的；然而，还需要更多的多中心研究和随机试验来确定SP平台将发挥何种作用。
结论
SP平台并非是一个渐进式的步骤或小众系统，它为单部位腹腔镜或机器人技术提供了一种新方法，并被证明是几种主要机器人泌尿外科手术的一种可行方法。虽然需要进行比较研究来评估SP平台和多孔平台在围手术期和长期结果方面的差异，但进一步的技术进步将继续推动外科医生采用创伤更小、更微创的手术方法。
Introduction The da Vinci Single-Port (SP) platform (Intuitive Surgical Inc, Sunnyvale CA) is a recently approved robotic surgical platform which features several novel modifications from previously available single trocar models including a flexible camera, articulating instruments, and navigator guidance for real-time monitoring of instrument position. We sought to describe our clinical experience with this device as well as to review the current literature related to the use of the SP platform. Methods We provide a narrative review of clinical data related to single-port robotic surgery within the field of urology. In addition, we report our initial clinical experience for surgical procedures performed with the SP platform between December 2018 and April 2019 following installation of the system at our institution. Results Currently, the presently available literature for single-port robotic urological surgery consists of single-center case reports and series. Most major robotic urologic operations appear technically feasible using the da Vinci SP platform; however, additional multi-center studies and randomized trials are needed to determine what role the SP platform will play. Conclusions Rather than an iterative step or a niche system, the SP platform provides for a new approach to single-site laparoscopic or robotic techniques and is demonstrated as a feasible approach for several major robotic urological operations. While comparative studies will be required to evaluate perioperative and long-term outcomes between SP and multi-port platforms, further technological advances will continue to push surgeons towards less morbid and more minimally invasive approaches for surgery.