单孔腹腔镜手术在消化外科的应用

Although natural orifice transluminal endoscopic surgery provides excellent cosmesis,it is not being widely accepted because of the restriction in aspects of technology,instruments and ethics.As a bridge,laparoendoscopic single site surgery(LESS)has been widely applied in digestive surgery,including bariatric,gastric,hepatobiliary and colorectal surgery.Although LESS provides excellent cosmetic results,and its safety and feasibility seems similar to conventional laparoscopy in most procedures,its effectiveness in the treatment of malignant tumors still needs to be proved. Compared with conventional laparoscopy,LESS has the drawbacks of longer operation time and higher demand in experience.Besides,because digestive tract reconstruction is often needed after resection,more convenient and applicable instruments need to be invented for the development of LESS.     

单孔腹腔镜手术在消化外科中的应用

With advances in surgical techniques,laparoseopic surgical instruments and constant equipment innovation,minimally invasive surgery has become the main stream of this century.Wide range of applications...     

机器人手术系统在肝脏外科中的应用

机器人手术系统具有稳定、清晰及放大的3D视野,可滤过术者手部震颤,具有多个自由度的灵活稳定操作,克服了传统腹腔镜的不足。尽管机器人手术系统在泌尿外科、妇产科等外科领域得到广泛应用,但在肝脏外科中的作用仍未得到充分认识。笔者综合国内外相关文献,结合团队经验,针对机器人手术系统在肝脏外科应用中的适应证、机器人手术系统肝切除...     

我国手术机器人外科面临的机遇和挑战

<正>进入21世纪,以da Vinci外科手术系统(daVinci surgical system,DVSS)为代表的手术机器人以其全新的理念和技术优势,克服了腹腔镜技术的不足,在国外得到越来越广泛的应用,并取得了良好的效果[1,2]。近年来,国内少数医院也相继引进     

外科机器人的研究进展及临床应用

由于机器人技术的迅速发展,微创外科将进入一个新的时代。以伊索（AEsOP）系统、宙斯（Zeus）系统、达芬奇（da Vinci）系统为代表的第一代机器人手术系统已应用于临床,而新兴的经腹腔镜或人体自然腔道人路的体内微型机器人,也不断取得技术上的重大突破,并在动物试验中显示出独特的优势。本文将概述当前两类外科手术机器人的研究进展及其在临床上的应用。     

外科机器人的发展历程及临床应用

一、机器人手术系统的发展历史机器人技术源于1495年莱昂纳多·达芬奇的设计,而普及则得益于1921年捷克作家卡尔.卡佩克的剧作《罗素姆万能机器人》和创造了“机器人技术(Robotics)”这个词的美国科幻作家伊萨克·阿西莫夫。1985年,外科医生首次使用一种能自主定位的立体定向装置(Puma560)来完成脑组织活检及以后的经尿道前列腺切除手术[1]。1991年,骨科机器人Robodoc被用于辅助完成全髋关节置换手术。1996年诞生了世界上首个远程手术工作站,可允许医生在异地通过微波通讯来完成可移动部队医院(mobile army surgical hospital,MASH)的手…     

机器人辅助腹腔镜手术在肝胆胰外科中的应用

正微创是21世纪外科发展的趋势。与传统手术相比,微创手术具有病人痛苦少、住院时间短和术后并发症发生率低等优势,且两者临床效果相当。由于肝胆胰功能重要、解剖复杂、神经血管丰富,传统腹腔镜下完成手术操作往往较困难。20世纪90年代发展的达芬奇机器人手术系统,提供三维立体手术视野,Endowrist机械手具有7个自由度,且可滤过术者手部颤动,增加手术操作的精准度和灵活性。这些特     

腹腔镜与内镜联合技术在消化外科疾病诊治中的应用

近年来,新兴出现的腹腔镜与内镜联合技术,充分发挥了软硬镜各自优势,取长补短,为彼此创造出有利条件,弥补了单一内镜或腹腔镜技术不足,使某些临床棘手问题迎刃而解,进一步拓展了微创技术的应用领域[1-2].     

机器人腹腔镜手术及其应用前景

随着腹腔镜技术和设备发展 ,腹腔镜手术应用范围不断扩大 ,需精细操作而时间较长的手术不断出现。机器人可部分取代枯燥、重复、劳累的操作。利用机器人系统图像的稳定性和精细的器械 ,可完成小管道吻合等常规腹腔镜手术时难度较大的操作。机器人腹腔镜系统将医师的操作转变成了电信号 ,传导给机器人操作臂 ,由此奠定了远程手术的基础。本文拟介绍机器人腹腔镜手术系统发展现状及其应用前景。机器人腹腔镜手术系统　　机器人腹腔镜手术系统主要由控制台和操作臂两部分组成。控制台是机器人系统的核心 ,由计算机系统、手术操作监视器、机器人…     

磁锚定技术在消化外科的应用

With the development of minimally invasive surgery,great developments have been made in laparoscopie techniques and digestive endoscopy.However,laparoscopy may cause injury by abdominal puncture,and digestive endoscopy is a painful examination for patients and is difficult to localize the tumor.Magnetic anchor makes use of magnetic attraction in positioning,and it improves laparoscopy and endoscopy by external magnetic field or magnetic handle.Nowadays,combined application of magnetic anchor and laparoscope and endoscope in the treatment of digestive diseases has been accepted by many medical centers,and further researches need to be carried out to realize the aim(small trauma,little pain and quick recovery)of minimally invasive surgery.     

腹腔镜胃肠手术消化道重建方式的探讨

腹腔镜下消化道重建是腹腔镜胃肠手术的重点和难点.近年来,随着腹腔镜吻合技术的进步,腹腔镜胃肠手术消化道重建方式不断完善更新,最终将形成有别于传统开放手术的技术体系.本文就目前腹腔镜胃肠术后消化道重建的现状和发展趋势做一总结.同时,结合笔者的经验,重点就腹腔镜胃癌术后反式抵钉座置入术、腹腔镜直肠癌术后超低位保肛技术、原位肛门重建技术逐一介绍和分析.     

达芬奇机器人手术系统行胰腺手术消化道吻合的要点

达芬奇机器人手术系统具有三维立体视野、高度精确性、灵活性和可重复性等优点,特别是在完成胰腺消化道吻合操作时,有着明显的优势.本文详细介绍了达芬奇机器人手术系统在胰腺手术中完成消化道吻合的可行性、吻合原则以及胰肠吻合、胰胃吻合手术步骤,从中分析出达芬奇机器人手术系统在胰腺手术消化道吻合时的特点,旨在提高吻合质量,减少术后胰腺吻合口相关并发症的发生.与开腹手术比较,在达芬奇机器人手术系统下完成胰腺消化道吻合简化了操作,减轻了创伤,是安全可行的.其具体吻合方式的选择应综合考虑局部组织条件、手术方式与外科医师的手术经验.     

Updates in robotic colorectal surgery

Since the introduction of master-slave manipulators (otherwise known as telemanipulators) in 1990, minimally invasive surgery paved way for the development of the first robotic surgical systems to overcome the limitations of laparoscopic surgery. Over the last decade, the robotic system has rapidly gained acceptance and popularity among surgeons, especially colorectal surgeons around the world. Advantages of robotic surgical systems includes superior instrumentation and stable field of vision which enable precise dissection in confined spaces such as the pelvis. The feasibility and safety of robotic rectal surgery is now well established and there is increasing evidence that it might offer superior perioperative and postoperative outcomes when compared to laparoscopic rectal surgery. Robotic rectal surgery is easier to learn than laparoscopic surgery and the creation of a structured training program for robotic rectal surgery in Europe and USA has facilitated the learning of this technique in an environment that promotes patient safety and improved patient outcomes through equipment fidelity and operator skills. It is foreseeable that in the near future robotic systems will become part of routine surgical practice in colorectal surgery.     

Updates in robotic colorectal surgery

Since the introduction of master-slave manipulators (otherwise known as telemanipulators) in 1990, minimally invasive surgery paved the way for the development of the first robotic surgical systems to overcome the limitations of laparoscopic surgery. The robotic system over the last decade has rapidly gained acceptance and popularity among surgeons, especially colorectal surgeons around the world. Advantages of robotic surgical systems includes superior instrumentation and stable field of vision which enable precise dissection in confined spaces such as the pelvis. The feasibility and safety of robotic rectal surgery is now well established and there is increasing evidence that it might offer superior perioperative and postoperative outcomes when compared to laparoscopic rectal surgery. Robotic rectal surgery is easier to learn than laparoscopic surgery and the creation of a structured training program for robotic rectal surgery in Europe and USA has facilitated the learning of this technique in an environment that promotes patient safety and improved patient outcomes through equipment fidelity and operator skills. It is foreseeable that in the near future robotic systems will become part of routine surgical practice in colorectal surgery.     

机器人手术系统在结直肠手术的应用

腹腔镜手术改善了结直肠手术患者的短期预后且有着不劣于开腹手术的长期预后,但对骨盆狭窄的低位直肠癌男性患者或肥胖的右半结肠癌患者,因其空间窄、暴露困难及腔镜器械灵活不足,腹腔镜手术的开展存在一定难度。机器人手术系统有视野更清晰、操作更灵活等优点而逐渐在结直肠手术中得到推广,但目前对于机器人手术系统在结直肠领域的应用现状和效果并不明确。本文将从手术机器人在传统结直肠手术中应用、机器人结直肠手术新进展、机器人手术不足三方面进行综述。     

Review on challenges for robotic eye surgery; surgical systems,technologies, cost-effectiveness,and controllers

In recent decades, a number of surgical systems have been developed and are applied for a growing variety of surgeries. This review will consider the significant challenges of robotic surgery for the eye. These challenges take into account the different eye diseases, available technologies, and costs in different surgical systems for the eye. The conditions of a suitable controller will be discussed with consideration of relevant control engineering concepts. Comparison is made between the different characteristics of surgical robots for the eye. In this review, some comparisons will be made in eye surgical robots, control algorithms, sensors in surgical robots, communication protocols, and actuators.