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Roboterunterstützte kolorektale Chirurgie

Entwicklungen und Perspektiven

Robotic colorectal surgery

Current status and future developments

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Zusammenfassung

Roboterunterstützte operative Verfahren verfügen über potenzielle Vorteile gegenüber den technisch vergleichsweise limitierten laparoskopischen Vorgehensweisen in der Chirurgie. Das daVinci®-System stellt das derzeit einzige kommerziell verfügbare roboterunterstützte Verfahren in der operativen Medizin dar. Bei der operativen Versorgung des Rektumkarzinoms gewann das Verfahren durch seine vergleichsweise niedrigen Konversionsraten zu einem offenen Vorgehen zwischenzeitlich an Zustimmung. Trotz dieses erkennbaren Vorteils hat der technische Fortschritt des roboterunterstützten operativen Vorgehens bislang jedoch zu keinem objektiv nachvollziehbaren Vorteil für die Patienten geführt. Der erste Teil dieses Artikels gibt daher einen Überblick über das gegenwärtige daVinci-System, seine Anwendungsmöglichkeiten, bisherige Datengrundlage und Perspektiven für die kolorektale Chirurgie. Der zweite Teil zeigt weitere in Entwicklung befindliche Robotersysteme sowie verschiedene Innovationen und Strategien zur Weiterentwicklung minimalinvasiver chirurgischer Techniken auf.

Abstract

Robotic assistance has the potential to compensate for the limitations inherent in standard laparoscopic surgery. The daVinci® surgical system remains the only currently available commercial robotic system. It has found popularity in rectal cancer surgery where its application has consistently been shown to reduce the need to convert to open surgery. With this exception, the technological advances of the robotic system have not so far translated into any reproducible patient benefit. The first part of this manuscript presents an overview of the current daVinci® platform, its applications, the evidence base and future developments in colorectal surgery. The second part of the manuscript looks at other robot systems in development and the different innovations and strategies taken to advance minimally invasive surgery.

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Authors and Affiliations

  1. St James’s University Hospital & University of Leeds, Level 7 Clinical Sciences Building, LS9 7TF, Leeds, Großbritannien

    D. Jayne

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  1. D. Jayne
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Correspondence to D. Jayne.

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Übersetzt ins Deutsche von Prof. Dr. Martin Gasser, Chirurgische Universitätsklinik Würzburg.

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Jayne, D. Roboterunterstützte kolorektale Chirurgie. Chirurg 84, 635–642 (2013). https://doi.org/10.1007/s00104-013-2499-7

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