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Roboterchirurgie in der Gynäkologie – Status quo

Robotic-assisted surgery in gynecology—status quo

  • Gynäkologie aktuell
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Die roboterassistierte Chirurgie ist die dynamischste Weiterentwicklung minimal-invasiver Eingriffe unserer Zeit und stellt keine Alternative zur Laparoskopie, sondern die nächste Stufe der technischen Evolution derselben dar.

Die Fortentwicklung der roboterassistierten Chirurgie mit der Einführung des da Vinci® Xi (Intuitive Surgical) ermöglicht nun den variablen Einsatz der Optik in allen 4 Trokaren. Durch die neue Geometrie des „patient cart“ ist eine Operation in allen Raumrichtungen ohne Umdocken möglich. Längere Instrumente und gleichzeitig die deutlich schmälere Mechanik des „patient cart“ erlaubt eine deutlich höhere Flexibilität. Interdisziplinäres Zusammenarbeiten sowie Kooperationen über große Distanzen sind durch die Telemetrie möglich geworden. Die zweite Konsole und der Operationssimulator eröffnen eine neue Dimension der Weiterbildung in chirurgischen Fächern. Nachteilig sind nach wie vor die hohen Anschaffungs- und Erhaltungskosten. Wie bei jeder neuen Technologie muss das medizinische Personal vor Beginn geschult werden, um diese sicher beherrschen zu können. Die operative Ausbildung kann erheblich mittels virtuellen Trainingsprogrammen sowie über die parallel schaltbare zweite Konsole gefördert werden.

Abstract

Robotic-assisted surgery is the most dynamic further development of minimally invasive surgery of our time and the next step of its technical evolution. The expansion to the DaVinci Xi module has led to a multivariable application. All four trocars have the same diameter and the altered geometry of the patient cart allow 4 quadrant surgery, and the camera to be changed to any trocar when necessary. The reduced size of all components and concomitantly increase in length of instruments allows a higher flexibility in all types of surgery. The table motion allows change of the degree of Trendelenburgs positioning without docking off the system. The second console and the simulator tool lead to new dimensions in surgical education. Cooperation over long distances and interdisciplinary teamwork are possible by telemetry. The biggest largest disadvantages are the high costs. Medical staff has tomust be trained before using the new technology to perform safe procedures.

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Authors and Affiliations

  1. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 24, 24105, Kiel, Deutschland

    Ibrahim Alkatout M.A.,  Nicolai Maass &  Johannes Ackermann

  2. Klinik für Allgmein-, Thorax-, Viszeral- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 24, 24105, Kiel, Deutschland

    Jan-Hendrik Egberts

  3. Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 24, 24105, Kiel, Deutschland

    Klaus-Peter Jünemann

  4. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland

    Rainer Kimmig

Authors
  1. Ibrahim Alkatout M.A.
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  2. Nicolai Maass
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  3. Jan-Hendrik Egberts
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  4. Klaus-Peter Jünemann
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  5. Johannes Ackermann
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  6. Rainer Kimmig
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Correspondence to Ibrahim Alkatout M.A..

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Interessenkonflikt

I. Alkatout, N. Maass, J.-H. Egberts, K.-P. Jünemann, J. Ackermann und R. Kimmig geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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W. Janni, Ulm

R. Kimmig, Essen

N. Maass, Kiel

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Alkatout, I., Maass, N., Egberts, JH. et al. Roboterchirurgie in der Gynäkologie – Status quo. Gynäkologe 49, 470–476 (2016). https://doi.org/10.1007/s00129-016-3881-6

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