国产机器人手术系统在妇科手术中的应用

Application of Domestic Robotic Surgical Systems in Gynecologic Surgery

摘要

近年来，国产手术机器人系统在妇科手术领域的探索逐渐从实验室阶段走向临床应用，呈现出多点突破、加速发展的态势。各类国产手术机器人系统如图迈、精锋、术锐、海山一及妙手S等，已相继在子宫肌瘤、卵巢囊肿以及宫颈癌、子宫内膜癌及卵巢癌等妇科恶性肿瘤的常规与复杂术式中开展临床实践，逐步构建起以“自主研发、临床验证、适应证拓展”为核心的国产技术路径。从手术操作角度看，国产系统普遍具备三维高清成像、机械臂灵活度高、精细解剖能力强等优势，能适应盆腔深部精密操作及多角度组织剥离需求，在部分复杂术式中可实现术中视野放大、操作稳定性提升及创伤控制优化。部分系统如术锐与精锋SP系列在单孔和自然腔道（如v-NOTES）路径下展现出良好适应性。此外，国产手术机器人系统已探索基于5G技术的远程手术，推动机器人手术在区域医疗协同与边远地区技术下沉方面取得初步进展。尽管目前大多数国产手术机器人系统仍处于临床研究和推广初期阶段，缺乏大规模对照研究与长期随访数据，但已有初步结果显示其在术中安全性、术后恢复及患者体验方面具备良好前景。本综述将从国产手术机器人的发展历程、技术特点、在妇科各类手术中的临床应用、远程手术应用现状以及面临的机遇与挑战等方面进行系统总结。相较于达芬奇系统，其在高难度肿瘤手术操作中的精细度、术中突发情况处理能力、长期肿瘤学结局验证等方面仍需进一步数据支撑。因此，未来亟待通过大样本、多中心、长期随访的前瞻性研究，验证其在妇科肿瘤治疗中的疗效与安全性，以促进国产机器人系统在妇科临床的规范化应用。

Abstract

In recent years, domestically developed surgical robot systems have rapidly progressed from laboratory research to clinical applications in gynecological surgery, demonstrating multi-dimensional advancement and accelerated development. Systems such as Toumai, Jingfeng, Surui, Haishanyi, and MicroHand S have been progressively deployed in both routine and complex procedures, including surgeries for uterine fibroids, ovarian cysts, and gynecologic malignancies such as cervical, endometrial, and ovarian cancers. These systems have established a technology pathway characterized by independent research and development, clinical validation, and expanded indications. They generally offer advantages such as 3D high-definition imaging, highly flexible robotic arms, and precise dissection capabilities, enabling refined operations in the deep pelvis and supporting multi-angle tissue dissection with enhanced visualization, stability, and trauma control. Some systems, including the Surui and Jingfeng SP series, have also demonstrated strong adaptability in single-port and natural orifice (e.g., v-NOTES) approaches. Additionally, 5G-based telesurgery has been preliminarily explored, promoting regional medical collaboration and technology dissemination in underserved areas. Although most domestic systems remain in early-stage clinical adoption with limited large-scale comparative studies and long-term follow-up data, initial outcomes are promising in terms of intraoperative safety, postoperative recovery, and patient experience. However, compared to the Da Vinci system, further evidence is needed regarding their precision in highly complex tumor resections, management of intraoperative complications, and long-term oncological outcomes. Therefore, large-sample, multi-center, prospective studies with long-term follow-up are urgently needed to validate their efficacy and safety and to promote standardized application in gynecological oncology.

关键词

国产机器人手术系统 / 妇科手术 / 远程手术 / 综述

Key words

Domestically produced robotic surgical systems / Gynecological surgery / Remote surgery / Review

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