中国实用外科杂志

中国实用外科杂志

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机器人辅助食管裂孔疝手术临床应用进展

杨媛媛，黄鹤光   

  1. 福建医科大学附属协和医院基本外科，福建福州350001
  • 出版日期:2021-04-01 发布日期:2021-04-20

  • Online:2021-04-01 Published:2021-04-20

摘要： 机器人食管裂孔疝（HH）修补术的优势在于操作精准度高、病人住院时间缩短、术后复发率低，随访期间有满意的生活质量和影像学结果。由于现阶段机器人设备昂贵、手术费用高，导致其与腹腔镜手术相比优势不够显著，在手术时间、再入院率、急性并发症发生率和病死率等方面差异无统计学意义。因此，部分研究结果认为在原发性HH和抗反流手术中使用机器人手术系统没有明显的优势，不建议在此类手术中使用机器人手术系统。HH手术治疗的“金标准”仍无定论，个体化制定手术方案，选择适合的手术方式，以提高疗效、降低并发症发生率为目标，改善病人生活质量是临床上最应该考虑的问题。机器人HH修补术安全可行，近期疗效较好，在精细解剖、精准缝合、微创方面有明显优势。

关键词: 食管裂孔疝, 机器人手术系统

Abstract: Application progress of Da Vinci robot system in hiatal hernia surgery        YANG Yuan-yuan, HUANG He-guang. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001，China
Corresponding author：HUANG He-guang，E-mail:hhuang2@
aliyun.com
Abstract    The advantages of robotic hiatal hernia (HH) repair are high accuracy，shorter hospital stay，low recurrence rate，and satisfactory quality of life and imaging results during follow-up. Due to the high cost of robot equipment and operation，it has no significant advantages compared with laparoscopic surgery. There is no significant difference in operation time，readmission rate，incidence of acute complications and mortality. Therefore，some studies suggest that the use of robotic surgery system in primary hiatal hernia repair and antireflux surgery has no obvious advantages，and it is not recommended to use robotic surgery system in such surgery. The "gold standard" of hiatal hernia surgical treatment is still inconclusive. It is the most important problem in clinical practice to make individualized operation plan，choose suitable operation method，improve the curative effect，reduce the incidence of complications and improve the quality of life of patients. Robotic hiatal hernia repair is safe and feasible，with good short-term effect，and has obvious advantages in fine anatomy，precise suture and minimally invasive.  

Key words: hiatal hernia, Da Vinci robot system, robotic surgery