内容紹介
Current Status of Robotic Surgery for Gastric Cancer
Summary
Robotic surgery was launched in Japan in 2000. In particular, the development of the da Vinci S Surgical System was a major breakthrough. It was introduced in Japan for the first time through our hospital in January 2009. Since then, the number of surgical robots used has been dramatically increasing, with up to approximately 160 robots all over the country. To date, we have performed more than 500 robotic surgeries, including 180 gastrectomies, at our hospital. Our data suggest that compared with the conventional laparoscopic approach, the use of the da Vinci Surgical System in minimally invasive gastrectomy for gastric cancer might improve short-term outcomes, particularly in terms of preventing postoperative local complications. Thus, we believe that use of surgical robots become increasingly beneficial for more extensive resections and operations that require more advanced skills, even though a couple of issues remain to be solved, such as long operative time, high cost, and limited experience and evidence. In this article, the current status and future perspectives regarding robotic gastrectomy for gastric cancer are presented based on our experience and a review of the literature.
要旨
ロボット支援手術の歴史は浅く,当初戦場や無医村における遠隔手術を目的として開発され,1997年3月より臨床応用が始まった。本邦では2009年11月に内視鏡手術支援ロボットda Vinci S HD Surgical System(Intuitive Surgical, Inc., Sunnyvale, CA, USA)が薬事法承認され,2012年4月から前立腺全摘術に対するロボット加算が保険収載された。2014年2月現在,国内のda Vinci保有台数は161台となり,本邦は世界第2位のロボット保有国となっている。当科では2009年からda Vinci S HD Surgical Systemを臨床導入し,上部消化管外科領域の悪性疾患に対して積極的に使用してきた。本稿では,その臨床経験を基に,胃癌に対するロボット支援手術の現状と展望について概説する。
目次
Summary
Robotic surgery was launched in Japan in 2000. In particular, the development of the da Vinci S Surgical System was a major breakthrough. It was introduced in Japan for the first time through our hospital in January 2009. Since then, the number of surgical robots used has been dramatically increasing, with up to approximately 160 robots all over the country. To date, we have performed more than 500 robotic surgeries, including 180 gastrectomies, at our hospital. Our data suggest that compared with the conventional laparoscopic approach, the use of the da Vinci Surgical System in minimally invasive gastrectomy for gastric cancer might improve short-term outcomes, particularly in terms of preventing postoperative local complications. Thus, we believe that use of surgical robots become increasingly beneficial for more extensive resections and operations that require more advanced skills, even though a couple of issues remain to be solved, such as long operative time, high cost, and limited experience and evidence. In this article, the current status and future perspectives regarding robotic gastrectomy for gastric cancer are presented based on our experience and a review of the literature.
要旨
ロボット支援手術の歴史は浅く,当初戦場や無医村における遠隔手術を目的として開発され,1997年3月より臨床応用が始まった。本邦では2009年11月に内視鏡手術支援ロボットda Vinci S HD Surgical System(Intuitive Surgical, Inc., Sunnyvale, CA, USA)が薬事法承認され,2012年4月から前立腺全摘術に対するロボット加算が保険収載された。2014年2月現在,国内のda Vinci保有台数は161台となり,本邦は世界第2位のロボット保有国となっている。当科では2009年からda Vinci S HD Surgical Systemを臨床導入し,上部消化管外科領域の悪性疾患に対して積極的に使用してきた。本稿では,その臨床経験を基に,胃癌に対するロボット支援手術の現状と展望について概説する。