摘要:手术机器人在医疗卫生行业已广泛普及应用,其精细化操作、信息化集成及智能化控制使其在患者治疗过 程中可发挥重要作用。手术机器人可有效避免外科医师术中操作抖动、减缓术者操作疲劳并提供高清术野。此 外,机器人融合交叉多学科技术,可创新性催生术前数字化重建、术中导航配准及机器人远程手术等新型诊疗方 案,更有助于提升国民生命健康。虽然手术机器人目前已部分应用于临床实践,但其更新迭代较快,针对其安全 性及患者长期获益的探索也从未停止。因此,本文将对手术机器人在医疗领域的发展历程做一概述,系统总结目 前手术机器人的典型临床应用,并提出进一步研究的展望。
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腹腔镜手术较传统开放手术而言实现了手术的 微创化及操作的精细化,但传统腹腔镜手术依然存 在部分不足,如术中视野不清晰、缺乏图像立体 感、手术器械活动范围受限、主刀医生与助手配合 不一致等。手术机器人系统作为高度集成化高端医 疗设备,可在狭小空间内实现精细化手术操作,既 能满足人体工程学要求缓解术者疲劳,又可保持操 作稳定精准提升手术安全,同时降低患者术中创 伤、促进术后康复,符合手术微创化要求[1] 。目前手 术机器人领域发展迅速,既往研究大多针对特定疾 病或学科展开综述,缺乏对整体手术机器人应用的 概括与对比,笔者针对手术机器人的国内外发展历 程及在不同学科中的典型应用做此综述,以期促进 手术机器人领域的进一步发展。
1 手术机器人发展史
2 手术机器人在不同临床学科的典型应用
2.1 泌尿外科方向典型应用
2.2 骨科方向典型应用
2.3 血管介入方向典型应用
2.4 神经外科方向典型应用
3 国外手术机器人的发展现状
3.1 达芬奇机器人发展现状
3.2 Hugo RAS 机器人发展现状
4 国产手术机器人的发展现状
4.1 妙手 S 手术机器人系统
4.2 康多内镜手术机器人系统
4.3 图迈®Toumai®腔镜手术机器人
5 手术机器人的创新应用
6 展望和总结
6 展望和总结
手术机器人作为医用机器人的成熟应用方向, 发展迅速、应用前景广阔。各类学科的交叉融合也 为手术机器人的发展迎来了新的契机,远程手术等 先进诊疗方式或将推动未来就医模式的新变化。但 目前手术机器人对于精准力反馈、准确可靠操作以 及系统小型化、便携化、保密化等需求的实现,仍 有待于进一步探索。随着机器人性能的不断改进及 创新应用的不断挖掘,手术机器人必成为未来就医 诊疗不可或缺的重要因素。
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