Robotic Surgery of the Liver and Biliary Tract
Robotic Surgery of the Liver and Biliary Tract
复制标题
DOI：
10.1089/lap.2017.0628
复制
发表时间：
2019-02-01
影响因子：
1.3
通讯作者：
Coratti, Andrea
中科院分区：
文献类型：
--
作者：
Guerra, Francesco;Di Marino, Michele;Coratti, Andrea
背景：腹部大手术的腹腔镜方法在全世界范围内越来越被接受。尽管机器人技术在临床实践中的引入相对较新，但它已被认为是执行高要求手术（例如肝胆手术所需手术）的有效选择。人们已经提出了相对于传统腹腔镜检查的一些潜在优势，但其在临床实践中的实际作用仍有待确定。方法：这项工作的目的是严格审查机器人手术应用于肝脏和胆道的现有证据。我们系统地检索了 PubMed、Embase 和 Cochrane 图书馆电子数据库，以查找有关机器人肝胆手术的研究报告，无论是否与开放手术或传统腹腔镜手术进行比较。结果：这篇综述全面介绍了机器人目前在肝脏和胆道手术中的应用。总体可用数据显示机器人系统不劣于传统的开放式和腹腔镜手术。许多研究表明，以微创方式进行高要求手术具有一些潜在的优势。结论：尽管缺乏与开放手术和腹腔镜手术进行比较的随机对照试验，机器人可以非常安全和有效地执行各种类型的肝脏手术，从而排除了得出明确结论的可能性。
Background: The laparoscopic methods for major abdominal surgery are gaining increasing acceptance worldwide. Despite its relatively recent introduction in clinical practice, robotics has been accepted as an effective option to perform high-demanding procedures such as those required in hepatobiliary surgery. Some potential advantages over conventional laparoscopy have been suggested, but its actual role in clinical practice is still to be defined. Methods: The objective of this work is to critically review the available evidence on the application of robotic surgery to the liver and biliary tract. PubMed, Embase, and the Cochrane Library electronic databases were systematically searched for studies reporting on robotic hepatobiliary surgery with or without comparison with open surgery or conventional laparoscopy. Results: This review provides a comprehensive snapshot of the current application of the robot to the surgery of the liver and biliary tract. The overall available data show the noninferiority of the robotic system to conventional open and laparoscopic surgery. A number of studies suggest some potential advantages in performing high-demanding procedures in a minimally invasive fashion. Conclusions: The robot can be used to perform various types of liver surgeries quite safely and competently, although the lack of randomized control trials, comparing it with open and laparoscopic surgery, precludes the possibility to reach definitive conclusions.