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中华结直肠疾病电子杂志 ›› 2014, Vol. 03 ›› Issue (01) : 34 -37. doi: 10.3877/cma.j.issn.2095-3224.2014.01.09

所属专题: 机器人手术 文献

综述

机器人技术在结直肠肿瘤外科中的应用
陈竟文1, 韦烨1, 许剑民1,()   
  1. 1. 200032 上海,复旦大学附属中山医院普外科
  • 收稿日期:2014-01-18 出版日期:2014-02-25
  • 通信作者: 许剑民
  • Received:2014-01-18 Published:2014-02-25
引用本文:

陈竟文, 韦烨, 许剑民. 机器人技术在结直肠肿瘤外科中的应用[J]. 中华结直肠疾病电子杂志, 2014, 03(01): 34-37.

表1 三代外科手术技术特点比较表
? 传统开放手术 腹腔镜手术 达芬奇机器人手术
眼手协调 自然的眼手协调 眼手协调降低,视觉范围和操作器械的手不再同一个方向 图像和控制手柄在同一个方向,符合自然的眼手协调
手术控制 术者直接控制手术野,但不精细,有时受限制 术者须和持镜的助手配合,才能看到自己想看的视野 术者自行调整镜头,直接看到想看的视野
成像技术 直视三维立体图像,但细微结构难以看清 二维平面图像,分辨率不够高,图像易失真 直视三维立体高清图像,放大10~15倍,比人眼更清晰
灵活性和精准程度 用手指和手腕控制器械,直观、灵活,但有时达不到理想的精度 器械只有4个自由度,不如人手灵活、精确 仿真手腕器械有7个自由度,比人手更灵活、准确
器械控制 直观的同向控制 穿刺孔逆转器械的动作,医生需反向操作器械 器械完全模仿术者的动作,直观的同向控制
稳定性 人手存在自然的颤抖 穿刺孔通过器械放大了人手的震颤 控制器自动滤除震颤,使得器械比人手稳定
创伤性 创伤较大,术后恢复慢 微创,术后恢复较快 微创,术后恢复较快
安全性 常规的手术风险 常规的手术风险外,存在一些机械故障的可能 常规的手术风险外,机械故障的几率大于腔镜手术系统
术者姿势 术者站立完成手术 术者站立完成手术 术者采取坐姿,利于完成长时间、复杂的手术
力反馈 直接 通过腔镜器械反馈 缺失,没有手感
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