| セッション情報 | シンポジウム13(消化器外科学会)肝胆膵外科領域におけるロボット・腹腔鏡下手術の現状と課題 |
|---|---|
| タイトル | S13-基調講演1：Current limitations and future perspectives of robotic and laparoscopic surgeries in hepato-biliary-pancreatic diseases. |
| 演者 | K.-H. Kim（Asan Medical Center, University of Ulsan College of Medicine） |
| 共同演者 | |
| 抄録 | Minimally invasive surgical procedures have gained widespread acceptance among surgeons and patients. Sophisticated technologies, such as digital optics, energized dissection systems, and medical instrumentation enable surgeons to perform a number of complex operations laparoscopically, including organ procurement from live donors in which the safety of healthy volunteers cannot be compromised. These advanced minimally invasive procedures require surgeons to have highly developed laparoscopic skills, including suturing, knot tying, and complex bimanual manipulation. However, conventional laparoscopic surgery has limitations, including reduced freedom of movement within the abdominal cavity and the fact that it provides 2-dimensional views of a 3-dimensional operative field. Recently, the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA, USA), a robotic surgical system, was approved by the US Food and Drug Administration for use in surgery. The da Vinci system is the only commercially available therapeutic robotic system on the market and allows surgeons to perform advanced laparoscopic procedures with greater ease. Similar to a human hand, the robotic articulating instruments translate the natural movements of the surgeon’s hand into precise movements inside the abdominal cavity. The system allows 3-dimensional views of the operative field, has tremor filtration capacity, and permits 7º of freedom. This allows surgeons to dexterously perform delicate dissections and precise intracorporeal suturing. The significant advantages of robotic surgery have expanded the scope of surgical procedures that can be performed through minimally invasive techniques. In this chapter, the authors describe the operative procedure of robotic liver resection. Robotic surgical systems offer an alternative to laparoscopic liver resection for minimally invasive liver resections. Well-trained surgeons can perform both major and minor liver resections through the robotic approach. Although little data regarding robotic liver resection have been reported, robotic liver resection appears to be similar to laparoscopic liver resection in terms of operative time, estimated blood loss, hospital stay, and time to resumption of a normal diet. However, robotic liver resection is more expensive than laparoscopic resection. Robotic liver resection may become more popular for minimally invasive liver surgery if upgraded robotic surgical systems can be developed that are smaller, cost less, have good tactile feedback and incorporate various hepatic parenchymal transection tools such as CUSA and Liga-sure. |
| 索引用語 |