关键词: 肝胆管结石病, 腹腔镜, da Vinci手术机器人

Abstract:

Application and evaluation of laparoscopic and robotic-assisted laparoscopic surgery  in the treatment of hepatolithiasis        ZHENG Shu-guo. Institute of Hepatobiliary Surgery，Southwest Hospital，the Third Military Medical University，Chongqing 400038，China
Abstract    The incidence of hepatolithiasis is high in some areas of China. As its classic treatment method，traditional open surgery exists more trauma，slow recovery and other issues. In recent years，advances in laparoscopic techniques and equipment updates，especially the introduction of da Vinci surgical robot in clinical practice has provided a new way for the treatment of hepatolithiasis. Currently，laparoscopic surgery has been widely used in the treatment of intrahepatic bile duct stones，and has been proven to achieve the same therapeutic effect with open surgery，including stone clearance，residual and recurrence rate with short-term efficacy advantage of less trauma，fast postoperative recovery and cosmetic incision. The indication of laparoscopic surgery is mainly for early regional type hepatolithiasis. da Vinci surgical robot can overcome the limitations of conventional laparoscopic surgery in terms of vision and instrumentation flexibility，making the minimally invasive treatment of complex hepatolithiasis possible. Based on the limited clinical experience，surgical robot system is safe and feasible in the treatment of selectively complex hepatolithiasis，especially for those with hilar bile duct stricture which need plasty and reconstruction. Because of  the reported cases of complicated hepatolithiasis treated by using surgical robot procedure are few，it still need large sample and long-term follow-up to study indications，efficacy and technical methods of the minimally invasive approach in the treatment of intrahepatic bile duct stones.

Key words: hepatolithiasis, laparoscopy, da Vinci surgical robotic system