机器人手术治疗胃癌的临床新进展

New Clinical Progress in the Treatment of Gastric Cancer by Robotic Surgery

摘要: 目前针对胃癌患者的外科手术治疗主要有开腹手术(open gastrectomy, OG)，腹腔镜下胃癌切除术(Laparoscopic gastrectomy, LG)，以及机器人胃切除(robotic gastrectomy, RG)。随着外科微创技术的快速发展，开腹手术相对于微创手术有更多的侵入性，伤口疼痛的感受更强，较长恢复排便功能和出院时间等。而在微创技术中，腹腔镜的二维图像应用、不可预防的生理性震颤和触觉下降以及面对一些复杂患者时强加给外科医生不舒服的姿势等情况都极大影响了外科医生操作的准确性与便捷性。因此，开发了机器人系统来解决此类问题。国内外多项研究表明，机器人胃切除术是安全可行的，且短期和长期结果与腹腔镜胃切除术相似。由于5G技术的出现，为机器人平台的发展带来了新的热情，同时使得全智能机器人手术成为可能。此篇文章将主要从手术模式和其他优势阐述机器人手术的临床进展。

Abstract: Currently, Laparoscopic gastrectomy (OG), laparoscopic gastrectomy (LG), and robotic gastrectomy (RG) are laparoscopic surgical treatments for patients with gastric cancer. Due to the rapid devel-opment of surgical minimally invasive technology, compared with minimally invasive procedure, open surgery is more invasive, with stronger feelings of wound pain, longer recovery of defecation function and discharge time. In minimally invasive technology, the application of two-dimensional images of laparoscopy, unpredictable physiological tremors and tactile decline, as well as imposing uncomfortable postures on surgeons when facing complex patients, all greatly affect the accuracy and convenience of surgeons’ operations. Therefore, robotic systems have been developed to solve such problems. The development of the robotic platform has become enthusiastic due to its im-proved ergonomic stability, high-definition 3D visualization of the surgical area, and a greater range of instrument motion. A number of domestic and international studies have shown that robotic gastrectomy is safe and feasible, and the short-term and long-term results are similar to laparo-scopic gastrectomy. Due to the development of 5G technology, robotic platforms have brought new enthusiasm and made fully intelligent robotic surgery possible. This article will mainly explain ro-botic surgery’s clinical progress from the surgical mode perspective and other advantages.