Abstract:

Application of robotic surgical system in the treatment of liver neoplasms: Current status and limitations                           WANG Xiao-ying. Department of Liver Surgery，Zhongshan Hospital，Fudan University，Shanghai 200032，China
Abstract    Robotic platforms has overcome many of the limitations of conventional laparoscopic surgery. The indications for robotic liver surgery include all the indications for laparoscopic liver surgery and comprise both benign lesions and malignancies. The current literatures and data demonstrate that robotic liver surgery is a feasible and safe option. In properly selected patients，robotic approach associated with less invasion and fast recovery compared to open approach. Both robotic and laparoscopic approaches are similar in perioperative outcomes and long-term oncologic outcomes. Robotic approach may increase percentage of major hepatectomies in a purely minimally invasive fashion，facilitate the resection of superior and posterior liver tumors，and provide better precision in intracorporeal biliary and vascular reconstruction. However，robotic approach has significantly longer operative time and higher cost. Since the case number of available study was probably too small to allow firm conclusions，large randomized studies are needed to compare robotic liver surgery with conventional laparoscopy and open surgery.

Key words: robotic surgical system, liver neoplasm, liver resection

摘要：

机器人手术系统克服了传统腹腔镜技术的内在缺陷，已应用于各种良、恶性肝脏肿瘤手术中。机器人肝脏手术涵盖了所有腹腔镜肝脏手术的适应证。现有的文献资料提示机器人肝肿瘤手术安全有效。对于适宜病例，机器人手术较开放手术创伤小、恢复快；与传统腹腔镜手术相比，机器人手术在近、远期疗效方面与之相当。机器人手术系统在微创大范围肝切除、后上段等困难部位肝切除、需重建血管及胆道的复杂肝切除术中有一定优势；但也存在手术费用高、手术时间长等局限。鉴于现阶段研究报道例数有限，尚需大样本前瞻性随机对照研究进一步评估其优缺点。

关键词: 机器人手术系统, 肝脏肿瘤, 肝切除术