機器人系統在血管外科的應用進展_《中國修復重建外科雜志》

作者：

賈森皓 , 熊江 , 衛任 , 郭偉

解放軍總醫院血管外科（北京，100853）;

關鍵詞：

機器人系統微創手術腔內介入治療血管外科

DOI：

10.7507/1002-1892.20130302

視頻：

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目的總結機器人系統在血管外科的應用進展。方法查閱近年國內外機器人系統治療血管外科疾病的相關文獻，進行總結分析。結果目前機器人系統主要分為手術機器人系統及腔內介入機器人系統兩類。手術機器人系統使血管旁路術中的血管吻合時間及血管阻斷時間明顯縮短，并且能完成血管分離暴露操作。腔內介入機器人系統具有良好的導航功能及穩定性，在通過特殊解剖部位及復雜病變時具有明顯優勢。目前，高昂費用是限制機器人系統廣泛應用的主要因素，觸覺反饋缺失也是急需解決的問題。結論機器人系統在治療血管外科疾病方面具有明顯優勢及良好前景，但在適應證及禁忌證確定、標準化術式制定、遠期療效評價等方面仍需大量臨床試驗加以明確。

引用本文： 賈森皓,熊江,衛任,郭偉. 機器人系統在血管外科的應用進展. 中國修復重建外科雜志, 2013, 27(11): 1395-1399. doi: 10.7507/1002-1892.20130302 復制

1.	Ayala Yáñez R, Olaya Guzmán EJ, Haghenbeck Altamirano FJ. Robotics in gynecology. Background, feasibility and applicability. Ginecol Obstet Mex, 2012, 80(6): 409-416.
2.	Steenwyk B, Lyerly R 3rd. Advancements in robotic-assisted thoracic surgery. Anesthesiol Clin, 2012, 30(4): 699-708.
3.	楊明, 高長青, 肖蒼松, 等. 機器人微創房間隔缺損修補術54例. 中國體外循環雜志, 2011, 9(4): 214-216.
4.	周漢新, 余小舫, 李富榮, 等. 遙控宙斯機器人膽囊切除術的臨床應用. 中華醫學雜志, 2005, 85(3): 154-157.
5.	Anderson KM, Ruckle HC, Baldwin DD. Robotic-assisted surgery and the evolution of the radical prostatectomy. Minerva Urol Nefrol, 2012, 64(2): 97-122.
6.	Sim HG, Yip SK, Cheng CW. Equipment and technology in surgical robotics. World J Urol, 2006, 24(2): 128-135.
7.	Tan GY, Goel RK, Kaouk JH, et al. Technological advances in robotic-assisted laparoscopic surgery. Urol Clin North Am, 2009, 36(2): 237-249, ix.
8.	Marescaux J, Leroy J, Gagner M, et al. Transatlantic robot-assisted telesurgery. Nature, 2001, 413(6854): 379-380.
9.	Hanly EJ, Talamini MA. Robotic abdominal surgery. Am J Surg, 2004, 188(4A Suppl): 19S-26S.
10.	Oleynikov D. Robotic surgery. Surg Clin North Am, 2008, 88(5): 1121-1130, viii.
11.	Challacombe BJ, Khan MS, Murphy D, et al. The history of robotics in urology. World J Urol, 2006, 24(2): 120-127.
12.	Desgranges P, Bourriez A, Javerliat I, et al. Robotically assisted aorto-femoral bypass grafting: lessons learned from our initial experience. Eur J Vasc Endovasc Surg, 2004, 27(5): 507-511.
13.	Nio D, Diks J, Linsen MA, et al. Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: early clinical experience. Eur J Vasc Endovasc Surg, 2005, 29(6): 586-590.
14.	Stádler P, Matous P, Vitásek P, et al. Robot-assisted aortoiliac reconstruction: A review of 30 cases. J Vasc Surg, 2006, 44(5): 915-919.
15.	Diks J, Nio D, Jongkind V, et al. Robot-assisted laparoscopic surgery of the infrarenal aorta : the early learning curve. Surg Endosc, 2007, 21(10): 1760-1763.
16.	Stádler P. Role of the robot in totally laparoscopic aortic repair for occlusive and aneurysmal disease. Acta Chir Belg, 2009, 109(3): 300-305.
17.	Kolvenbach R, Schwierz E, Wasilljew S, et al. Total laparoscopically and robotically assisted aortic aneurysm surgery: a critical evaluation. J Vasc Surg, 2004, 39(4): 771-776.
18.	Coggia M, Javerliat I, Di Centa I, et al. Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience. J Vasc Surg, 2004, 40(5): 899-906.
19.	Cau J, Ricco JB, Marchand C, et al. Total laparoscopic aortic repair for occlusive and aneurysmal disease: first 95 cases. Eur J Vasc Endovasc Surg, 2006, 31(6): 567-574.
20.	Novotný T, Dvorák M, Staffa R. The learning curve of robot-assisted laparoscopic aortofemoral bypass grafting for aortoiliac occlusive disease. J Vasc Surg, 2011, 53(2): 414-420.
21.	Wisselink W, Cuesta MA, Gracia C, et al. Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: a report of two cases. J Vasc Surg, 2002, 36(5): 1079-1082.
22.	Lin JC, Reddy DJ, Eun D, et al. Robotic-assisted laparoscopic dissection of the infrarenal aorta and iliac artery: a technical description and early results. Ann Vasc Surg, 2009, 23(3): 298-302.
23.	Lin JC, Kaul SA, Bhandari A, et al. Robotic-assisted aortic surgery with and without minilaparotomy for complicated occlusive disease and aneurysm. J Vasc Surg, 2012, 55(1): 16-22.
24.	?Tádler P, Dvo?á?ek L, Vitásek P, et al. The application of robotic surgery in vascular medicine. Innovations (Phila), 2012, 7(4): 247-253.
25.	Luke P, Knudsen BE, Nguan CY, et al. Robot-assisted laparoscopic renal artery aneurysm reconstruction. J Vasc Surg, 2006, 44(3): 651-653.
26.	Pietrabissa A, Morelli L, Ferrari M, et al. Mixed reality for robotic treatment of a splenic artery aneurysm. Surg Endosc, 2010, 24(5): 1204.
27.	Lin JC, Eun D, Shrivastava A, et al. Total robotic ligation of inferior mesenteric artery for type II endoleak after endovascular aneurysm repair. Ann Vasc Surg, 2009, 23(2): 255. e19-21.
28.	Mehrabi A, Yetimoglu CL, Nickkholgh A, et al. Development and evaluation of a training module for the clinical introduction of the da Vinci robotic system in visceral and vascular surgery. Surg Endosc, 2006, 20(9): 1376-1382.
29.	Jongkind V, Diks J, Yeung KK, et al. Mid-term results of robot-assisted laparoscopic surgery for aortoiliac occlusive disease. Vascular, 2011, 19(1): 1-7.
30.	Chun KR, Schmidt B, Kokturk B, et al. Catheter ablation-new developments in robotics. Herz, 2008, 33(8): 586-589.
31.	Fu Y, Liu H, Huang W, et al. Steerable catheters in minimally invasive vascular surgery. Int J Med Robot, 2009, 5(4): 381-391.
32.	Ernst S. Robotic approach to catheter ablation. Curr Opin Cardiol, 2008, 23(1): 28-31.
33.	Tillander H. Magnetic guidance of a catheter with articulated steel tip. Acta radiol, 1951, 35(1): 62-64.
34.	Ram W, Meyer H. Heart catheterization in a neonate by interacting magnetic fields: a new and simple method of catheter guidance. Cathet Cardiovasc Diagn, 1991, 22(4): 317-319.
35.	Faddis MN, Blume W, Finney J, et al. Novel, magnetically guided catheter for endocardial mapping and radiofrequency catheter ablation. Circulation, 2002, 106(23): 2980-2985.
36.	Faddis MN, Chen J, Osborn J, et al. Magnetic guidance system for cardiac electrophysiology: a prospective trial of safety and efficacy in humans. J Am Coll Cardiol, 2003, 42(11): 1952-1958.
37.	Riga C, Bicknell C, Hamady MS, et al. Robotically-steerable catheters and their role in the visceral aortic segment. J Cardiovasc Surg (Torino), 2011, 52(3): 353-362.
38.	Saliba W, Cummings JE, Oh S, et al. Novel robotic catheter remote control system: feasibility and safety of transseptal puncture and endocardial catheter navigation. J Cardiovasc Electrophysiol, 2006, 17(10): 1102-1105.
39.	Saliba W, Reddy VY, Wazni O, et al. Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and long-term follow-up results. J Am Coll Cardiol, 2008, 51(25): 2407-2411.
40.	Kanagaratnam P, Koa-Wing M, Wallace DT, et al. Experience of robotic catheter ablation in humans using a novel remotely steerable catheter sheath. J Interv Card Electrophysiol, 2008, 21(1): 19-26.
41.	Bismuth J, Kashef E, Cheshire N, et al. Feasibility and safety of remote endovascular catheter navigation in a porcine model. J Endovasc Ther, 2011, 18(2): 243-249.
42.	Pappone C, Vicedomini G, Manguso F, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol, 2006, 47(7): 1390-1400.
43.	Iyengar S, Gray WA. Use of magnetic guidewire navigation in the treatment of lower extremity peripheral vascular disease: report of the first human clinical experience. Catheter Cardiovasc Interv, 2009, 73(6): 739-744.
44.	Riga C, Bicknell C, Cheshire N, et al. Initial clinical application of a robotically steerable catheter system in endovascular aneurysm repair. J Endovasc Ther, 2009, 16(2): 149-153.
45.	Carrell T, Dastur N, Salter R, et al. Use of a remotely steerable “robotic” catheter in a branched endovascular aortic graft. J Vasc Surg, 2012, 55(1): 223-225.
46.	Bismuth J, Duran C, Stankovic M, et al. A first-in-man study of the role of flexible robotics in overcoming navigation challenges in the iliofemoral arteries. J Vasc Surg, 2013, 57(2 Suppl): 14S-19S.
47.	Riga CV, Bicknell CD, Wallace D, et al. Robot-assisted antegrade in-situ fenestrated stent grafting. Cardiovasc Intervent Radiol, 2009, 32(3): 522-524.
48.	Riga CV, Rolls A, Rippel R, et al. Advantages and limitations of robotic endovacular catheters for carotid artery stenting. J Cardiovasc Surg (Torino), 2012, 53(6): 747-753.

1. Ayala Yáñez R, Olaya Guzmán EJ, Haghenbeck Altamirano FJ. Robotics in gynecology. Background, feasibility and applicability. Ginecol Obstet Mex, 2012, 80(6): 409-416.
2. Steenwyk B, Lyerly R 3rd. Advancements in robotic-assisted thoracic surgery. Anesthesiol Clin, 2012, 30(4): 699-708.
3. 楊明, 高長青, 肖蒼松, 等. 機器人微創房間隔缺損修補術54例. 中國體外循環雜志, 2011, 9(4): 214-216.
4. 周漢新, 余小舫, 李富榮, 等. 遙控宙斯機器人膽囊切除術的臨床應用. 中華醫學雜志, 2005, 85(3): 154-157.
5. Anderson KM, Ruckle HC, Baldwin DD. Robotic-assisted surgery and the evolution of the radical prostatectomy. Minerva Urol Nefrol, 2012, 64(2): 97-122.
6. Sim HG, Yip SK, Cheng CW. Equipment and technology in surgical robotics. World J Urol, 2006, 24(2): 128-135.
7. Tan GY, Goel RK, Kaouk JH, et al. Technological advances in robotic-assisted laparoscopic surgery. Urol Clin North Am, 2009, 36(2): 237-249, ix.
8. Marescaux J, Leroy J, Gagner M, et al. Transatlantic robot-assisted telesurgery. Nature, 2001, 413(6854): 379-380.
9. Hanly EJ, Talamini MA. Robotic abdominal surgery. Am J Surg, 2004, 188(4A Suppl): 19S-26S.
10. Oleynikov D. Robotic surgery. Surg Clin North Am, 2008, 88(5): 1121-1130, viii.
11. Challacombe BJ, Khan MS, Murphy D, et al. The history of robotics in urology. World J Urol, 2006, 24(2): 120-127.
12. Desgranges P, Bourriez A, Javerliat I, et al. Robotically assisted aorto-femoral bypass grafting: lessons learned from our initial experience. Eur J Vasc Endovasc Surg, 2004, 27(5): 507-511.
13. Nio D, Diks J, Linsen MA, et al. Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: early clinical experience. Eur J Vasc Endovasc Surg, 2005, 29(6): 586-590.
14. Stádler P, Matous P, Vitásek P, et al. Robot-assisted aortoiliac reconstruction: A review of 30 cases. J Vasc Surg, 2006, 44(5): 915-919.
15. Diks J, Nio D, Jongkind V, et al. Robot-assisted laparoscopic surgery of the infrarenal aorta : the early learning curve. Surg Endosc, 2007, 21(10): 1760-1763.
16. Stádler P. Role of the robot in totally laparoscopic aortic repair for occlusive and aneurysmal disease. Acta Chir Belg, 2009, 109(3): 300-305.
17. Kolvenbach R, Schwierz E, Wasilljew S, et al. Total laparoscopically and robotically assisted aortic aneurysm surgery: a critical evaluation. J Vasc Surg, 2004, 39(4): 771-776.
18. Coggia M, Javerliat I, Di Centa I, et al. Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience. J Vasc Surg, 2004, 40(5): 899-906.
19. Cau J, Ricco JB, Marchand C, et al. Total laparoscopic aortic repair for occlusive and aneurysmal disease: first 95 cases. Eur J Vasc Endovasc Surg, 2006, 31(6): 567-574.
20. Novotný T, Dvorák M, Staffa R. The learning curve of robot-assisted laparoscopic aortofemoral bypass grafting for aortoiliac occlusive disease. J Vasc Surg, 2011, 53(2): 414-420.
21. Wisselink W, Cuesta MA, Gracia C, et al. Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: a report of two cases. J Vasc Surg, 2002, 36(5): 1079-1082.
22. Lin JC, Reddy DJ, Eun D, et al. Robotic-assisted laparoscopic dissection of the infrarenal aorta and iliac artery: a technical description and early results. Ann Vasc Surg, 2009, 23(3): 298-302.
23. Lin JC, Kaul SA, Bhandari A, et al. Robotic-assisted aortic surgery with and without minilaparotomy for complicated occlusive disease and aneurysm. J Vasc Surg, 2012, 55(1): 16-22.
24. ?Tádler P, Dvo?á?ek L, Vitásek P, et al. The application of robotic surgery in vascular medicine. Innovations (Phila), 2012, 7(4): 247-253.
25. Luke P, Knudsen BE, Nguan CY, et al. Robot-assisted laparoscopic renal artery aneurysm reconstruction. J Vasc Surg, 2006, 44(3): 651-653.
26. Pietrabissa A, Morelli L, Ferrari M, et al. Mixed reality for robotic treatment of a splenic artery aneurysm. Surg Endosc, 2010, 24(5): 1204.
27. Lin JC, Eun D, Shrivastava A, et al. Total robotic ligation of inferior mesenteric artery for type II endoleak after endovascular aneurysm repair. Ann Vasc Surg, 2009, 23(2): 255. e19-21.
28. Mehrabi A, Yetimoglu CL, Nickkholgh A, et al. Development and evaluation of a training module for the clinical introduction of the da Vinci robotic system in visceral and vascular surgery. Surg Endosc, 2006, 20(9): 1376-1382.
29. Jongkind V, Diks J, Yeung KK, et al. Mid-term results of robot-assisted laparoscopic surgery for aortoiliac occlusive disease. Vascular, 2011, 19(1): 1-7.
30. Chun KR, Schmidt B, Kokturk B, et al. Catheter ablation-new developments in robotics. Herz, 2008, 33(8): 586-589.
31. Fu Y, Liu H, Huang W, et al. Steerable catheters in minimally invasive vascular surgery. Int J Med Robot, 2009, 5(4): 381-391.
32. Ernst S. Robotic approach to catheter ablation. Curr Opin Cardiol, 2008, 23(1): 28-31.
33. Tillander H. Magnetic guidance of a catheter with articulated steel tip. Acta radiol, 1951, 35(1): 62-64.
34. Ram W, Meyer H. Heart catheterization in a neonate by interacting magnetic fields: a new and simple method of catheter guidance. Cathet Cardiovasc Diagn, 1991, 22(4): 317-319.
35. Faddis MN, Blume W, Finney J, et al. Novel, magnetically guided catheter for endocardial mapping and radiofrequency catheter ablation. Circulation, 2002, 106(23): 2980-2985.
36. Faddis MN, Chen J, Osborn J, et al. Magnetic guidance system for cardiac electrophysiology: a prospective trial of safety and efficacy in humans. J Am Coll Cardiol, 2003, 42(11): 1952-1958.
37. Riga C, Bicknell C, Hamady MS, et al. Robotically-steerable catheters and their role in the visceral aortic segment. J Cardiovasc Surg (Torino), 2011, 52(3): 353-362.
38. Saliba W, Cummings JE, Oh S, et al. Novel robotic catheter remote control system: feasibility and safety of transseptal puncture and endocardial catheter navigation. J Cardiovasc Electrophysiol, 2006, 17(10): 1102-1105.
39. Saliba W, Reddy VY, Wazni O, et al. Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and long-term follow-up results. J Am Coll Cardiol, 2008, 51(25): 2407-2411.
40. Kanagaratnam P, Koa-Wing M, Wallace DT, et al. Experience of robotic catheter ablation in humans using a novel remotely steerable catheter sheath. J Interv Card Electrophysiol, 2008, 21(1): 19-26.
41. Bismuth J, Kashef E, Cheshire N, et al. Feasibility and safety of remote endovascular catheter navigation in a porcine model. J Endovasc Ther, 2011, 18(2): 243-249.
42. Pappone C, Vicedomini G, Manguso F, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol, 2006, 47(7): 1390-1400.
43. Iyengar S, Gray WA. Use of magnetic guidewire navigation in the treatment of lower extremity peripheral vascular disease: report of the first human clinical experience. Catheter Cardiovasc Interv, 2009, 73(6): 739-744.
44. Riga C, Bicknell C, Cheshire N, et al. Initial clinical application of a robotically steerable catheter system in endovascular aneurysm repair. J Endovasc Ther, 2009, 16(2): 149-153.
45. Carrell T, Dastur N, Salter R, et al. Use of a remotely steerable “robotic” catheter in a branched endovascular aortic graft. J Vasc Surg, 2012, 55(1): 223-225.
46. Bismuth J, Duran C, Stankovic M, et al. A first-in-man study of the role of flexible robotics in overcoming navigation challenges in the iliofemoral arteries. J Vasc Surg, 2013, 57(2 Suppl): 14S-19S.
47. Riga CV, Bicknell CD, Wallace D, et al. Robot-assisted antegrade in-situ fenestrated stent grafting. Cardiovasc Intervent Radiol, 2009, 32(3): 522-524.
48. Riga CV, Rolls A, Rippel R, et al. Advantages and limitations of robotic endovacular catheters for carotid artery stenting. J Cardiovasc Surg (Torino), 2012, 53(6): 747-753.

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機器人系統在血管外科的應用進展

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《中國修復重建外科雜志》

機器人系統在血管外科的應用進展

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