1魏丽梅，2肖连珍
中山大学附属第三医院手术室 广东 广州 510630
【 Abstract 】 Since Da Vinci robot was introduced into China, it has been used in many operating rooms of third-class hospitals, solving many problems that are difficult to be solved by traditional surgery. With the emergence of the fourth generation of Da Vinci robot,
The operation time has been further reduced, the complexity of the operation process has been further simplified, the success rate of the operation has been further improved for the majority of patients to bring the good news, so that the minimally invasive procedures have been further developed, very
Worth popularizing.
1 Introduction to Da Vinci Surgical System
1 .1Introduction to Da Vinci Surgical System
Da Vinci Surgical System is an advanced version of the robot platform. It consists of not only a robot, but also a surgeon's console, a bedside robotic arm system, and an imaging system, as shown in the figure below:
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1 .2Comparison between the first-generation and the fourth-generation
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2 Application of the Fourth Generation Da Vinci Surgical System
2 .1Urology Surgery
As we all know, laparoscopic techniques have already got a lot of application in urology surgery, such as renal resection, adrenal resection, ureteral incision, bladder tumor resection, tumor resection of the prostate, etc., but because of the particularity of urology surgery, doctors need to spend a long time to master the corresponding laparoscopic surgery, very not easy to master, also easy to appear a few small mistakes.The use of surgical robot greatly solves this problem, because the surgical robot provides a wide field of vision, which is very convenient for doctors to accurately analyze the structure of lesions and accurate surgery.Among them[1], radical prostatectomy is the most able to reflect its technical advantages of surgery, in Europe and the United States and other countries, radical prostatectomy has been more than 95% using the Da Vinci system.
2 .2Gynecology Urology
Generally speaking, most gynecological surgery is completed in the pelvic cavity, but the human body's pelvic cavity is very narrow, which makes the operation of the field of vision is very small, the freedom of movement of laparoscopic instruments is greatly constrained, if the face of some need to separate the operation, it is more difficult to do.With Da Vinci's wide field of vision, doctors can quickly improve the resolution of lesions, and remote control instruments can be inserted into the pelvic cavity through the incision to cut away the lesions without harming the surrounding tissues.Ninety percent of gynecological operations in the United States are now performed using the da Vinci system
2 .3Cardiothoracic Surgery
Cardiothoracic surgery generally requires open-chest surgery, so it is not suitable for minimally invasive surgery. For an open-chest surgery, the operation time is often more than 4 hours, and some even reach more than 10 hours. It is a physical race for doctors and nurses.If a doctor's strength is exhausted, he is liable to make all sorts of mistakes.With the help of Da Vinci system, the master doctor does not need to change clothes, but only needs to sit on the surgical table and guide the robotic arm to do it. If he wants to have a rest, he can also leave for a while to have a meal or drink coffee, which greatly reduces the working intensity of the doctor.
2 .4Gastrointestinal Surgery
A lot of gastrointestinal surgery is now using minimally invasive laparoscopic surgery, because gastroenteroscopy usually requires inserting three catheters and a lens tube into the patient's abdomen, requiring at least four nurses or auxiliary doctors to hold the four tubes, otherwise the tubes tend to lean to one side.
Due to medical personnel is more, the natural cost is higher, increase the patient's spending, the Da Vinci system, everything becomes very simple, all four catheter by mechanical control, do not need to medical staff fixed with the hand, even worse, when need to tilt the patient's body, the fourth generation of the Da Vinci system can automatically tilted beds, the other tube at the same time, avoid the catheter in the patient's body touch, greatly improve the security of the operation.
3 Performance comparison between the fourth and third generation Da Vinci systems
4 summarize
Although leonardo Da Vinci has made quite a powerful technological progress, has been greatly ahead of laparoscopic surgery, but it has some disadvantages, first of all, the weight of the Da Vinci system is overweight, eight, bulky, between normal operation can't bear such a heavy equipment, need special customized room, at the same time, the high cost of formalities, often boot fee will be tens of thousands, the average family can't afford to, along with the increase in number of patients, cost should be decreased, but the key still need engineers use new materials to reduce costs, reduce weight, convenient for the general hospital to buy a place.
references
[1] 尹军 , 刘相花 , 唐海英 , 等 . 手术机器人的研究进展及其在临床中的应用 [J]. 医疗卫生装备 ,2017,38(11):97-100.