内容紹介
Current Status and Future Prospects of Robotic Surgery for Lung Cancer
Summary
As the use of robotic surgery has widely spread, its usefulness in the field of general thoracic surgery needs to be verified. The biggest advantage of robotic surgery is the remarkably free movement of joint-equipped robotic forceps under 3-dimensional high vision. An accurate operation makes complex procedures straightforward and may overcome the disadvantages of previous thoracoscopic surgery. Robotic surgery for lung cancer has been safely introduced, and the initial results have been favorable. While still at the stage of clinical research, it is expected to be useful in hilar exposure, lymph node dissection, and suturing of lung parenchyma or bronchus. We considered robotic surgery for lung cancer surgery because of its ability to facilitate both thoracotomy and minimally invasive video-assisted thoracic surgery. Robotic thoracic surgery has not been sufficiently examined for its usefulness, and other major issues such as safety management, education, and significant cost need to be addressed. However, it may become an extension of thoracoscopic surgery, and studies showing its usefulness for primary lung cancer have been increasing. Two urgent issues are its use in advanced medical care and national health insurance coverage.
要旨
手術支援ロボットの普及が進むなかで呼吸器外科領域における有用性の検証が求められている。ロボット手術の最大の利点は,三次元視野下に関節を有する自由度の高い鉗子を用いて巧みな手術操作ができるところである。これらの利点は胸腔鏡手術の弱点を補い,複雑な手術を容易にし,精緻な手術を可能にしてくれる。肺癌に対するロボット手術は現在までのところ初期成績は安全に導入され,有用な結果が示されている。未だ臨床研究の段階ではあるが,肺門剥離操作,リンパ節郭清,肺や気管支の縫合操作に有用性の期待がかかる。肺癌に対するロボット手術は,胸腔鏡手術の低侵襲性と開胸手術の操作性を兼ね備えた魅力を有すると考えられるが,胸腔鏡手術を凌駕するエビデンスは未だ明らかにされていない。安全性,教育,多大なコストも大きな問題である。今後は技術の向上とともにロボット手術の有用性を示すデータが蓄積されていくだろう。現在,先進医療,保険収載に向けての準備が急がれている。
目次
Summary
As the use of robotic surgery has widely spread, its usefulness in the field of general thoracic surgery needs to be verified. The biggest advantage of robotic surgery is the remarkably free movement of joint-equipped robotic forceps under 3-dimensional high vision. An accurate operation makes complex procedures straightforward and may overcome the disadvantages of previous thoracoscopic surgery. Robotic surgery for lung cancer has been safely introduced, and the initial results have been favorable. While still at the stage of clinical research, it is expected to be useful in hilar exposure, lymph node dissection, and suturing of lung parenchyma or bronchus. We considered robotic surgery for lung cancer surgery because of its ability to facilitate both thoracotomy and minimally invasive video-assisted thoracic surgery. Robotic thoracic surgery has not been sufficiently examined for its usefulness, and other major issues such as safety management, education, and significant cost need to be addressed. However, it may become an extension of thoracoscopic surgery, and studies showing its usefulness for primary lung cancer have been increasing. Two urgent issues are its use in advanced medical care and national health insurance coverage.
要旨
手術支援ロボットの普及が進むなかで呼吸器外科領域における有用性の検証が求められている。ロボット手術の最大の利点は,三次元視野下に関節を有する自由度の高い鉗子を用いて巧みな手術操作ができるところである。これらの利点は胸腔鏡手術の弱点を補い,複雑な手術を容易にし,精緻な手術を可能にしてくれる。肺癌に対するロボット手術は現在までのところ初期成績は安全に導入され,有用な結果が示されている。未だ臨床研究の段階ではあるが,肺門剥離操作,リンパ節郭清,肺や気管支の縫合操作に有用性の期待がかかる。肺癌に対するロボット手術は,胸腔鏡手術の低侵襲性と開胸手術の操作性を兼ね備えた魅力を有すると考えられるが,胸腔鏡手術を凌駕するエビデンスは未だ明らかにされていない。安全性,教育,多大なコストも大きな問題である。今後は技術の向上とともにロボット手術の有用性を示すデータが蓄積されていくだろう。現在,先進医療,保険収載に向けての準備が急がれている。