机器人辅助腹腔镜下根治性前列腺切除术的进展：手术入路、设备及技术优势与不足

Progress in robot-assisted radical prostatectomy: surgical approach, equipment, advantages and limitations

摘要

根治性前列腺切除术（RP）是早期局限性前列腺癌（PCa）的主要治疗方法。随着科技的进步，机器人辅助腹腔镜下RP（RARP）的临床应用越来越广泛，该方法可更好地实现“五连胜”，即长期肿瘤控制、尿控恢复、术后切缘阴性、勃起功能保留、减少术后并发症，明显提高了PCa的手术治疗效果。本文结合大量文献对RARP的手术入路（如经腹腔入路、经腹膜外入路、经膀胱入路、经会阴入路、单孔入路），可选手术设备现况（如达芬奇机器人、国产机器人），以及该手术方法的优势及不足等做一综述，以期为临床医师选择PCa的最佳手术方式提供参考。

Abstract

Radical prostatectomy (RP) is the main therapeutic method for early localized prostate cancer. With the advancement of technology, robot-assisted radical prostatectomy (RARP) is widely applied, which can enable better achievement of the “five wins”, including long-term tumor control, recovery of urinary control, negative surgical margins, preservation of erectile function, and reduced postoperative complications, thereby improving the treatment efficacy. This paper reviews the various surgical approaches (transabdominal, transperitoneal, transvesical, transperineal, single-hole), current status of optional surgical equipment (da Vinci surgical robot, domestic robot), and advantages and limitations of RARP, so as to provide reference for clinicians in choosing the optimal surgical method for prostate cancer.

关键词

前列腺癌 / 机器人辅助手术 / 腹腔镜 / 根治性前列腺切除术 / 手术入路

Key words

prostate cancer / robot-assisted surgery / laparoscope / radical prostatectomy / surgical approach

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