AI机器人技术在结直肠癌治疗中的现状与未来：技术革新与临床转化

The current situation and future of AI robot technology in the treatment of colorectal cancer：technological innovation and clinical transformation

摘要

集成人工智能(artificial intelligence，AI)算法的机器人手术系统作为智能外科与生物医学工程交叉融合的前沿成果，正在重塑结直肠癌治疗的技术范式。该系统集成高精度机械臂、多模态影像识别、实时决策算法与知识迁移学习机制，在狭窄盆腔内的淋巴清扫、吻合构建与神经保护等关键操作中展现出优势。与传统腹腔镜手术相比，集成AI算法的机器人手术系统可实现0.5~1.0 mm级操作精度，实现术中AI淋巴结识别准确率98.7%，淋巴结清扫数量较传统腹腔镜多15%~20%，吻合口瘘发生率下降2~3个百分点(5.4%降至1.9%)。手术平均出血量为50~80 mL，明显低于腹腔镜的90~120 mL。随着机器人平台的快速发展以及5G远程通信、数字孪生、强化学习等技术的深度融合，结直肠癌机器人手术系统正逐步向高智能化、个体化与远程协作化方向发展。然而，该技术仍存在触觉反馈缺失、多模态数据融合延迟、监管路径不清晰以及医工协作体系不足等关键挑战。文章系统综述了集成AI算法的机器人手术系统在结直肠癌外科中的发展历程、临床应用优势、核心技术瓶颈及未来演进方向，重点探讨其在智能感知、术中协同、远程手术与临床转化路径中的价值，旨在为外科医生、工程研究人员与卫生政策制定者提供跨学科的理论依据与实践参考。

Abstract

Robotic surgical systems integrated with artificial intelligence(AI)algorithms，as a frontier product at the intersection of intelligent surgery and biomedical engineering，are reshaping the technological paradigm of colorectal cancer treatment. These systems incorporate high-precision robotic arms，multimodal image recognition，real-time decision-making algorithms，and knowledge transfer learning mechanisms，demonstrating advantages in critical procedures such as lymphadenectomy，anastomotic construction，and nerve preservation within the confined pelvic cavity. Compared with conventional laparoscopic surgery，AI-integrated robotic systems can achieve an operating precision of 0.5-1.0 mm，an intraoperative lymph node recognition accuracy of 98.7%，and a 15%-20% increase in the number of lymph nodes dissected. The incidence of anastomotic leakage decreases by approximately 2-3 percentage points(from 5.4% to 1.9%)，while mean intraoperative blood loss is reduced to 50-80 mL，significantly lower than the 90-120 mL typically observed in laparoscopic procedures. In recent years，driven by the rapid evolution of robotic platforms and the deep integration of technologies such as 5G remote communication，digital twins，and reinforcement learning，colorectal cancer robotic surgery systems are progressing toward higher levels of intelligence，individualization，and remote collaboration. Nevertheless，key challenges remain in clinical implementation，including the lack of tactile feedback，delays in multimodal data fusion，unclear regulatory pathways，and insufficient medical-engineering collaborative frameworks. This review systematically summarizes the developmental trajectory，clinical advantages，core technical bottlenecks，and future directions of AI-integrated robotic systems in colorectal surgery，with particular emphasis on their value in intelligent perception，intraoperative coordination，remote surgery，and clinical translation pathways. The aim is to provide interdisciplinary theoretical foundations and practical references for surgeons，engineering researchers，and healthcare policymakers.

关键词

人工智能 / 手术机器人 / 结直肠癌 / 微创外科 / 生物医学工程

Key words

artificial intelligence / surgical robots / colorectal cancer / minimally invasive surgery / biomedical engineering

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基金资助

河北省卫计委医学科学重点课题计划(20200523)