内容紹介
Summary
Robotic-assisted surgery has been wide-spreading rapidly as a technique to develop laparoscopic surgery by innovative technological improvement such as high magnifided 3D-image and multi-degree freedom of forceps, leading to safety enhancement and better functional recovery. Robotic surgery in the urological field made it possible to highly fine operation in a narrow field, such as pelvic cavity or retroperitoneal space. Better outcomes were recognized especially in perioperative complications and postoperative QOL recovery than other procedures like open or laparoscopic. According to these results, radical prostatectomy, partial nephrectomy and radical cystectomy were approved for health insurance coverage in 2012, 2016 and 2018, respectively. Robotic-assistance has definitely brought a paradigm shift in urologic surgery. The application to more and more a variety of procedure and the improvement of treatment outcomes are expected in the future.
要旨
ダビンチを用いたロボット支援手術は高倍率3D HD画像,多自由度鉗子などの技術開発により,鏡視下手術は革新的に発展した。泌尿器科手術の多くは骨盤内や後腹膜腔など狭小な腔内で緻密な操作が必要となる。ロボット手術の導入により,立体的かつ精細な解剖の理解および縫合結紮など鉗子操作が大きく改善した。これらは手術の安全性や質の向上に明らかに寄与し,泌尿器腫瘍に対しては2012年前立腺癌全摘除術,2016年腎部分切除術,2018年には膀胱全摘除術が健康保険の適応を認可された。ロボット支援手術が泌尿器腫瘍の手術療法にパラダイムシフトをもたらしたことは間違いない。今後もますます多様な術式への応用と治療成績の向上が期待される。
目次
Robotic-assisted surgery has been wide-spreading rapidly as a technique to develop laparoscopic surgery by innovative technological improvement such as high magnifided 3D-image and multi-degree freedom of forceps, leading to safety enhancement and better functional recovery. Robotic surgery in the urological field made it possible to highly fine operation in a narrow field, such as pelvic cavity or retroperitoneal space. Better outcomes were recognized especially in perioperative complications and postoperative QOL recovery than other procedures like open or laparoscopic. According to these results, radical prostatectomy, partial nephrectomy and radical cystectomy were approved for health insurance coverage in 2012, 2016 and 2018, respectively. Robotic-assistance has definitely brought a paradigm shift in urologic surgery. The application to more and more a variety of procedure and the improvement of treatment outcomes are expected in the future.
要旨
ダビンチを用いたロボット支援手術は高倍率3D HD画像,多自由度鉗子などの技術開発により,鏡視下手術は革新的に発展した。泌尿器科手術の多くは骨盤内や後腹膜腔など狭小な腔内で緻密な操作が必要となる。ロボット手術の導入により,立体的かつ精細な解剖の理解および縫合結紮など鉗子操作が大きく改善した。これらは手術の安全性や質の向上に明らかに寄与し,泌尿器腫瘍に対しては2012年前立腺癌全摘除術,2016年腎部分切除術,2018年には膀胱全摘除術が健康保険の適応を認可された。ロボット支援手術が泌尿器腫瘍の手術療法にパラダイムシフトをもたらしたことは間違いない。今後もますます多様な術式への応用と治療成績の向上が期待される。