J 2008

Robotické výkony v kolorektální chirurgii

VLČEK, Petr, Ivan ČAPOV, Václav JEDLIČKA, Štěpán CHALUPNÍK, Jiří KORBIČKA et. al.

Basic information

Original name

Robotické výkony v kolorektální chirurgii

Authors

VLČEK, Petr, Ivan ČAPOV, Václav JEDLIČKA, Štěpán CHALUPNÍK, Jiří KORBIČKA, Lenka VEVERKOVÁ, Jan DOLEŽEL, Jiří JEŘÁBEK and Jan WECHSLER

Edition

Rozhledy v chirugii, Praha, Olympia, 2008, 0035-9351

Other information

Type of outcome

Článek v odborném periodiku

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Organization unit

Faculty of Medicine

Keywords in English

Robotic Surgery –Colorectal Surgery –Rectal Cancer-Pelvic Floor Dysorders
Změněno: 13/1/2009 23:13, MUDr. Petr Vlček, Ph.D.

Abstract

In English

Sumary: The da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA) was developed specifically to compensate the technical limitations of laparoscopic instruments, such as two-dimensional vision, misalignment of hands and instruments, limited dexterity of instruments inside the patient, and fixed instrument tips. The da Vinci system provides a stable camera platform, three-dimensional imaging, excellent ergonomics, tremor elimination, ambidextrous capability, motion scaling, and instruments with multiple degrees of freedom. These advantages can be applied in the field of colorectal surgery and we are reporting 45cases that underwent robotic colorectal surgery. We concluded that the da Vinci system may be useful in surgical procedures, such as splenic flexure takedown, dissection of the inferior mesenteric artery with identification of the nervous plexus, and dissection of a narrow pelvis. The major drawbacks of robotic systems are high cost, and a lack of tactile sensation and tensile feedback to the surgeon, who must depend on visual cues to estimate the tension exerted on tissue by the robotic arms. In conclusion, robotic colorectal surgery can be performed safely and effectively, using the da Vinci surgical system, because this system has more dexterity and flexibility than conventional laparoscopic instruments. However, prospective randomized studies are necessary to evaluate the preservation of sexual and voiding function, as well as the oncological and functional/pelvic floor dysorders/ outcomes of this approach.