Prospective study comparing standard and robotically assisted laparoscopic cholecystectomy
Prospective study comparing standard and robotically assisted laparoscopic cholecystectomy
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DOI：
10.1007/s00423-006-0046-4
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发表时间：
2006-06-01
影响因子：
2.3
通讯作者：
Mischinger, Hans Joerg
中科院分区：
文献类型：
--
作者：
Kornprat, Peter;Werkgartner, Georg;Mischinger, Hans Joerg
背景与目的：腹腔镜手术已成为胆囊切除术的首选治疗方法。许多研究表明，虽然这种方法对患者有益，但外科医生面临着明显的缺点，如不符合人体工程学的情况和受限的自由度，从而限制了运动。机器人有潜力克服这些问题。为了评估机器人辅助手术（RAC）的效率和可行性，我们设计了一项前瞻性研究，将其与标准腹腔镜胆囊切除术（SLC）进行比较。材料和方法：2001 - 2003年间，26例患者采用ZEUS系统行SLC， 20例患者行RAC。对其可行性、安全性和可能的优势进行了评价。为了评估疗效，将在手术室的总时间分为术前、术中和术后三个时间段。结果：RAC与SLC相比，包括设备设置在内的术前阶段明显更长。术中切口闭合时间、相机和套管针置入时间明显延长。值得注意的是，囊性动脉、导管和胆囊的净剥离时间与SLC没有什么不同。结论：该研究证明了机器人辅助胆囊切除术无系统特异性发病的可行性。由于设备的安装和拆卸，机器人手术的几个阶段存在时间损失，因此在腹腔镜胆囊切除术中使用机器人没有任何好处。
Background and aims: Laparoscopic surgery has become the treatment of choice for cholecystectomy. Many studies showed that while this approach benefits the patient, the surgeon faces such distinct disadvantages as a poor ergonomic situation and limited degrees of freedom with limited motion as a consequence. Robots have the potential to overcome these problems. To evaluate the efficiency and feasibility of robotically assisted surgery (RAC), we designed a prospective study to compare it with standard laparoscopic cholecystectomy (SLC). Materials and methods: Between 2001 and 2003, 26 patients underwent SLC and 20 patients underwent RAC using the ZEUS system. The feasibility, safety, and possible advantages were evaluated. To assess the efficacy, the total time in the operating room was divided into preoperative, operative, and postoperative time frames.Results: For RAC in comparison with SLC, the preoperative phase including equipment setup was significantly longer. In the intraoperative phase, the cut-closure time and camera and trocar insertion times were significantly longer. It is interesting to note that the net dissection time for the cystic artery, duct, and the gall bladder was not different from SLC.Conclusions: The study demonstrates the feasibility of robotically assisted cholecystectomy without system-specific morbidity. There is time loss in several phases of robotic surgery due to equipment setup and deinstallation and therefore, presents no benefit in using the robot in laparoscopic cholecystectomy.