少颖
(2025-08-03 01:07):
#paper DOI: https://doi.org/10.5114/ait/203168
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杂志:Anaesthesiol Intensive Ther 年份:2025
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标题:Anesthesia for robot-assisted surgery: a review
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推荐理由:手术机器人能够减轻医生的工作量减少病人的痛苦,这篇文章让我们明白了手术机器人的瓶颈,让我们知道未来如何发展手术机器人技术。
1.生理干扰大
手术依赖充二氧化碳建立气腹和头低脚高体位,会挤压心肺,导致血压波动、呼吸不畅,还可能引发颅内压、眼内压升高,增加脑水肿、视力损伤风险,术后面部颈部水肿也可能影响气道安全。
2.并发症风险高
可能出现气体栓塞(二氧化碳进入血管),导致血压骤降、心跳异常;虽出血量少,但一旦出血更难控制;长时间固定体位还可能压伤神经,引发手脚麻木或无力。
3.操作和空间限制
设备体积大,占用手术室空间,麻醉师难靠近患者,术前需固定好所有管线以防脱落;紧急情况需多步骤卸除机器人,可能延误抢救;手术时间因设备对接、学习曲线长而延长,增加患者低体温风险。
4.患者适用范围窄
严重肥胖、肺病、心脏病、青光眼等患者无法耐受;胸廓过小、有粘连病史的患者,机械臂难以摆放,无法手术。
5.成本高且依赖技术
设备昂贵,仅大型医院能负担;需术者专项培训,且完全依赖人工操作,无自主纠错能力,技术垄断也限制普及。
Anaesthesiology Intensive Therapy,
2025-5-26.
DOI: 10.5114/ait/203168
Anesthesia for robot-assisted surgery: a review
Małgorzata Barud,
Bartłomiej Turek,
Wojciech Dąbrowski,
Dorota Siwicka
Abstract:
Robotic surgery has become increasingly popular over the last 30 years. This technique<br>is particularly attractive due to its minimally invasive nature, high precision compared<br>to open and laparoscopic techniques, less postoperative pain, shorter hospital stay for<br>patients, and faster recovery. For an anesthesiologist, robot-assisted operations involve<br><br>numerous challenges resulting from the surgical technique. The most important problems during anesthesia include changes in physiology resulting from the development<br><br>of pneumoperitoneum and a steep Trendelenburg position. This review discusses problems that may be encountered by an anesthesiologist performing anesthesia during<br><br>robotic surgery.
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