机器人活体供肝切取术的现状与进展

李星霏; 罗湘; 李涛

doi:10.3969/j.issn.1674-7445.2022.06.006

机器人活体供肝切取术的现状与进展

doi: 10.3969/j.issn.1674-7445.2022.06.006

100044 北京，北京大学人民医院

基金项目:

北京市自然科学基金 7192212

详细信息

作者简介:

通讯作者:
李涛，Email：ltlitao@hotmail.com

中图分类号: R617, TP24
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- 文章访问数: 280
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- 被引次数: 0
出版历程
- 收稿日期: 2022-05-28
- 网络出版日期: 2022-11-14
- 刊出日期: 2022-11-15

Current status and progress on robot living donor liver hepatectomy

Peking University People's Hospital, Beijing 100044, China

More Information

Corresponding author: Li Tao, Email: ltlitao@hotmail.com

摘要

摘要: 随着微创外科及腹腔镜技术的产生、发展与创新，微创技术逐渐在外科各个领域进行应用与推广，适应证也在不断扩大。机器人外科手术系统因精准、微创成为了新的研究热点，复杂的肿瘤手术目前也可以使用机器人手术系统进行治疗。如何将机器人手术应用于肝移植领域，尤其是机器人在活体肝移植供肝切取中的应用，成为目前新的研究方向，是众多学者研究思考的问题。本文就机器人手术的优势、机器人活体供肝切取术的现状以及机器人活体供肝切取术存在的主要困难进行综述，并展望机器人活体供肝切取术的未来，为促进机器人手术在临床肝移植中的应用提供参考。
- 微创 /
- 手术系统 /
- 机器人 /
- 肝移植 /
- 供肝切取 /
- 腹腔镜 /
- 左外叶供肝 /
- 右半供肝
Abstract: With the emergence, development and innovation of minimally invasive surgical and laparoscopic technologies, minimally invasive technology has been gradually applied and promoted in different fields of surgery, and surgical indications have been constantly expanded. Robot-assisted surgical system has become a novel research hotspot due to its precision and minimal invasiveness. At present, robot-assisted surgical system can be applied in complex tumor surgery. How to apply robot-assisted surgery in the field of liver transplantation, especially in the living donor liver hepatectomy, has become a new research direction, which is also a challenge facing multiple scholars. In this article, the advantages of robot-assisted surgery, current status and major difficulties of robot living donor liver hepatectomy were reviewed, and the future of robot living donor liver hepatectomy was predicted, aiming to provide reference for promoting the application of robot-assisted surgery in clinical liver transplantation.
- Minimally invasive /
- Surgical system /
- Robot /
- Liver transplantation /
- Donor liver hepatectomy /
- Laparoscope /
- Left lateral lobe donor liver /
- Right half donor liver

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图 1 腹腔镜和机器人在肝脏手术中的优势

Figure 1. Advantages of laparoscopic and robotic in liver surgery

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表 1 RLDH的相关研究

Table 1. Researches on RLDH

研究团队	国家及地区	切取部分	例数（n）	临床结果	供者并发症	受者并发症	平均失血量（mL）
Giulianotti PC, et al^[4]	美国	肝右叶	1	手术时间480 min热缺血时间35 min	Clavien DindoⅢ级：门静脉狭窄	-^①	350
Broering DC, et al^[7]	沙特阿拉伯	肝右叶	35	手术时间504 min热缺血时间8 min无中转开腹	总体6% 无严重并发症（Clavien Dindo≥Ⅲ级）	总体49% Clavien DindoⅠ/Ⅱ级14%	250
Chen PD, et al^[13]	中国台湾地区	肝右叶	13	手术时间596 min热缺血时间9.5 min	总体7.7% Clavien DindoⅠ/Ⅱ级0	总体15.4%，Clavien Dindo≥Ⅲ级（肝动脉血栓形成7.7%，胆道并发症7.7%）	196
Troisi RI, et al^[15]	沙特阿拉伯	肝左外叶	25	手术时间290 min热缺血时间7 min无中转开腹	无	总体72% 胆漏4% 出血0	50
Rho SY, et al^[18]	韩国	肝右叶	52	手术时间493 min热缺血时间15 min中转开腹率1%	总体23.1%Clavien Dindo≥Ⅲ级3.8%	总体46.2%Clavien Dindo≥Ⅲ级24.9%	109
Liao MH, et al^[26]	中国大陆	肝左外叶	1	手术时间390 min热缺血时间15 min	无	Clavien DindoⅠ/Ⅱ级：轻度肺部感染	400
注：①-为无数据。

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