芒果视频下载

介紹

達(da)芬(fen)奇機(ji)器人手(shou)(shou)(shou)術(shu)(shu)系統(tong)(tong)(tong)以(yi)麻(ma)省(sheng)理(li)工學院(原名斯(si)坦福研(yan)(yan)究學院)研(yan)(yan)發(fa)的(de)機(ji)器人外科(ke)(ke)手(shou)(shou)(shou)術(shu)(shu)技術(shu)(shu)為基(ji)礎。Intuitive Surgical隨后(hou)與IBM、麻(ma)省(sheng)理(li)工學院和(he)Heartport公司聯手(shou)(shou)(shou)對(dui)該系統(tong)(tong)(tong)進行了進一步開(kai)發(fa)。FDA已經批準將達(da)芬(fen)奇機(ji)器人手(shou)(shou)(shou)術(shu)(shu)系統(tong)(tong)(tong)用(yong)于(yu)成人和(he)兒童的(de)普通(tong)外科(ke)(ke)、胸外科(ke)(ke)、泌尿(niao)外科(ke)(ke)、婦產科(ke)(ke)、頭頸(jing)外科(ke)(ke)以(yi)及心臟(zang)手(shou)(shou)(shou)術(shu)(shu)。達(da)芬(fen)奇外科(ke)(ke)手(shou)(shou)(shou)術(shu)(shu)系統(tong)(tong)(tong)是(shi)一種高級機(ji)器人平臺，其設計的(de)理(li)念(nian)是(shi)通(tong)過使用(yong)微創的(de)方(fang)法，實施復(fu)雜的(de)外科(ke)(ke)手(shou)(shou)(shou)術(shu)(shu)。

簡(jian)單地(di)說，達芬(fen)奇(qi)機器(qi)人就是高級的腹(fu)(fu)腔(qiang)鏡(jing)(jing)系(xi)統。大家可能對現在流行(xing)的微創治療手段如：胸腔(qiang)鏡(jing)(jing)、腹(fu)(fu)腔(qiang)鏡(jing)(jing)、婦科腔(qiang)鏡(jing)(jing)等(deng)有所了解(jie)，達芬(fen)奇(qi)機器(qi)人進行(xing)手術操作的時候(hou)也需要機械臂(bei)穿(chuan)過胸部、腹(fu)(fu)壁(bi)。

組成

達(da)芬奇機器(qi)人由三部分(fen)組成(cheng)(cheng)：外科醫生(sheng)控(kong)制(zhi)臺(tai)、床旁機械臂系統、成(cheng)(cheng)像(xiang)系統。

外科醫生控制臺

主(zhu)刀(dao)醫生(sheng)坐在控(kong)制(zhi)臺中(zhong)，位于手術室無(wu)菌(jun)區之外，使用雙手(通過操(cao)作兩個主(zhu)控(kong)制(zhi)器)及(ji)腳(jiao)(通過腳(jiao)踏板)來控(kong)制(zhi)器械(xie)和一個三(san)維高清內窺鏡。正如(ru)在立體目鏡中(zhong)看到的(de)那樣，手術器械(xie)尖端與外科醫生(sheng)的(de)雙手同步運動(dong)。

床旁機械臂系統

床旁(pang)機械臂(bei)系(xi)統(tong)(tong)(Patient Cart)是外科手(shou)術機器人的操作部件，其主要功能是為(wei)器械臂(bei)和(he)攝像臂(bei)提(ti)供支撐。助(zhu)手(shou)醫生(sheng)在無菌區內的床旁(pang)機械臂(bei)系(xi)統(tong)(tong)邊(bian)工作，負責更(geng)換(huan)器械和(he)內窺鏡，協助(zhu)主刀(dao)醫生(sheng)完成手(shou)術。為(wei)了確保患者安全(quan)，助(zhu)手(shou)醫生(sheng)比主刀(dao)醫生(sheng)對于床旁(pang)機械臂(bei)系(xi)統(tong)(tong)的運(yun)動具有(you)更(geng)高優先控制權。

成像系統

成像(xiang)系統(Video Cart)內裝有(you)外科手術(shu)機(ji)器(qi)人的核心處(chu)理器(qi)以(yi)及圖象處(chu)理設備(bei)，在手術(shu)過程中位(wei)于無菌區外，可由巡(xun)回(hui)護士操(cao)作，并可放置各類輔助手術(shu)設備(bei)。外科手術(shu)機(ji)器(qi)人的內窺鏡為(wei)高分辨(bian)(bian)率三(san)維(3D)鏡頭，對(dui)手術(shu)視野具有(you)10倍以(yi)上的放大(da)倍數(shu)，能為(wei)主刀醫生帶來患(huan)者體(ti)(ti)腔(qiang)內三(san)維立體(ti)(ti)高清影(ying)像(xiang)，使主刀醫生較普通腹腔(qiang)鏡手術(shu)更能把握(wo)操(cao)作距離，更能辨(bian)(bian)認解剖結構，提升了手術(shu)精(jing)確度(du)。

適應科室

泌尿外科

腹(fu)腔(qiang)(qiang)鏡技(ji)術(shu)(shu)(shu)被越來越廣(guang)泛地應用(yong)于泌(mi)尿(niao)外科手(shou)術(shu)(shu)(shu)，這(zhe)一微創的(de)(de)(de)手(shou)術(shu)(shu)(shu)方式適用(yong)于許多(duo)常規的(de)(de)(de)泌(mi)尿(niao)外科手(shou)術(shu)(shu)(shu)，如(ru)腎(shen)(shen)切(qie)(qie)除(chu)(chu)、腎(shen)(shen)上(shang)腺(xian)(xian)切(qie)(qie)除(chu)(chu)、輸尿(niao)管(guan)(guan)切(qie)(qie)開(kai)、膀胱(guang)腫(zhong)瘤(liu)切(qie)(qie)除(chu)(chu)、前列腺(xian)(xian)腫(zhong)瘤(liu)切(qie)(qie)除(chu)(chu)等(deng)。但(dan)由于泌(mi)尿(niao)系統(tong)解(jie)剖(pou)學上(shang)的(de)(de)(de)特(te)(te)殊(shu)性，限制了(le)腹(fu)腔(qiang)(qiang)鏡技(ji)術(shu)(shu)(shu)的(de)(de)(de)普及和(he)推(tui)廣(guang)，一些復雜的(de)(de)(de)手(shou)術(shu)(shu)(shu)往(wang)往(wang)難以掌握，而且手(shou)術(shu)(shu)(shu)并發癥發生率(lv)較高。目前國內(nei)的(de)(de)(de)孫穎浩教(jiao)授已經(jing)能(neng)(neng)很好(hao)的(de)(de)(de)運用(yong)手(shou)術(shu)(shu)(shu)機(ji)器(qi)人(ren)獨特(te)(te)的(de)(de)(de)深部操(cao)作和(he)精(jing)(jing)細(xi)操(cao)作的(de)(de)(de)技(ji)術(shu)(shu)(shu)優(you)(you)勢(shi)廣(guang)泛應用(yong)于各種泌(mi)尿(niao)外科手(shou)術(shu)(shu)(shu)，包括前列腺(xian)(xian)癌根(gen)治(zhi)、腎(shen)(shen)切(qie)(qie)除(chu)(chu)、腎(shen)(shen)盂成形、全膀胱(guang)切(qie)(qie)除(chu)(chu)、輸精(jing)(jing)管(guan)(guan)吻合、輸尿(niao)管(guan)(guan)成形、活(huo)體供腎(shen)(shen)切(qie)(qie)取(qu)等(deng)。其中，前列腺(xian)(xian)癌根(gen)治(zhi)術(shu)(shu)(shu)是最能(neng)(neng)體現(xian)其技(ji)術(shu)(shu)(shu)優(you)(you)勢(shi)的(de)(de)(de)手(shou)術(shu)(shu)(shu)，手(shou)術(shu)(shu)(shu)機(ji)器(qi)人(ren)提供寬闊視野和(he)準確(que)、靈活(huo)的(de)(de)(de)控制能(neng)(neng)力，能(neng)(neng)夠清(qing)楚呈現(xian)組織(zhi)、器(qi)官的(de)(de)(de)解(jie)剖(pou)構造(zao)和(he)神經(jing)血管(guan)(guan)束的(de)(de)(de)走(zou)行(xing)，精(jing)(jing)細(xi)的(de)(de)(de)分離有利(li)于淋巴結的(de)(de)(de)清(qing)掃，準確(que)的(de)(de)(de)縫合保證了(le)吻合的(de)(de)(de)高質量，手(shou)術(shu)(shu)(shu)中精(jing)(jing)確(que)保留前列腺(xian)(xian)側(ce)筋(jin)膜，有利(li)于減少手(shou)術(shu)(shu)(shu)對患者性生活(huo)的(de)(de)(de)影(ying)響(xiang)，術(shu)(shu)(shu)后病理檢查和(he)隨(sui)訪都顯示了(le)良好(hao)的(de)(de)(de)腫(zhong)瘤(liu)切(qie)(qie)除(chu)(chu)效(xiao)果。自2000年開(kai)展首例手(shou)術(shu)(shu)(shu)機(ji)器(qi)人(ren)前列腺(xian)(xian)癌根(gen)治(zhi)性切(qie)(qie)除(chu)(chu)以來，該術(shu)(shu)(shu)式在國外得到迅速(su)推(tui)廣(guang)。

目前，在(zai)北歐國(guo)家超過(guo)一半以上的前列(lie)腺癌(ai)根(gen)治手術由(you)手術機器(qi)人完(wan)成，而在(zai)美國(guo)，這一比例更是高達90%，已成為(wei)前列(lie)腺癌(ai)根(gen)治手術的“金標準”。

心胸外科

開放(fang)式心(xin)(xin)(xin)胸(xiong)(xiong)(xiong)外(wai)科手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)需要開胸(xiong)(xiong)(xiong)，分離胸(xiong)(xiong)(xiong)骨，游離肋(lei)骨，在體外(wai)循環(huan)下(xia)完成(cheng)(cheng)，手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)創(chuang)傷(shang)大(da)，手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)風險(xian)高(gao)，術(shu)(shu)(shu)(shu)后(hou)恢復時間長。胸(xiong)(xiong)(xiong)腔(qiang)鏡已用(yong)于(yu)(yu)肺葉(xie)切(qie)除(chu)、冠脈搭橋等(deng)心(xin)(xin)(xin)胸(xiong)(xiong)(xiong)外(wai)科手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)，這種微創(chuang)的(de)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)方(fang)法不用(yong)開胸(xiong)(xiong)(xiong)，僅需在肋(lei)間作幾個(ge)小切(qie)口，就能(neng)完成(cheng)(cheng)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)操作，病(bing)人(ren)(ren)痛苦小，術(shu)(shu)(shu)(shu)后(hou)恢復快。但其適用(yong)范(fan)圍(wei)有限，無(wu)法完成(cheng)(cheng)一(yi)些解(jie)剖結構復雜的(de)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)，因而(er)開展并不普及。手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)機器人(ren)(ren)最早(zao)于(yu)(yu)1999年(nian)完成(cheng)(cheng)了首例冠狀(zhuang)動脈旁路(lu)移植術(shu)(shu)(shu)(shu)，2003年(nian)起用(yong)于(yu)(yu)各種心(xin)(xin)(xin)臟(zang)(zang)(zang)外(wai)科直(zhi)視手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)。它在不破壞(huai)胸(xiong)(xiong)(xiong)廓完整性(xing)(xing)的(de)前提下(xia)，能(neng)精準(zhun)地(di)完成(cheng)(cheng)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)操作，而(er)且適應證范(fan)圍(wei)廣泛，幾乎涵蓋所有的(de)心(xin)(xin)(xin)胸(xiong)(xiong)(xiong)外(wai)科手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)，如心(xin)(xin)(xin)臟(zang)(zang)(zang)外(wai)科的(de)全腔(qiang)內心(xin)(xin)(xin)臟(zang)(zang)(zang)搭橋、心(xin)(xin)(xin)臟(zang)(zang)(zang)不停跳取(qu)乳內動脈、二尖瓣(ban)成(cheng)(cheng)型(xing)、二尖瓣(ban)置換、房間隔缺損修補、三尖瓣(ban)成(cheng)(cheng)型(xing)、心(xin)(xin)(xin)臟(zang)(zang)(zang)腫瘤切(qie)除(chu)，胸(xiong)(xiong)(xiong)外(wai)科的(de)肺葉(xie)切(qie)除(chu)術(shu)(shu)(shu)(shu)、食管癌(ai)切(qie)除(chu)、胸(xiong)(xiong)(xiong)腺切(qie)除(chu)術(shu)(shu)(shu)(shu)和(he)食管失弛(chi)緩癥的(de)治療等(deng)。其中，全腔(qiang)內心(xin)(xin)(xin)臟(zang)(zang)(zang)搭橋手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)和(he)二尖瓣(ban)成(cheng)(cheng)型(xing)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)是手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)機器人(ren)(ren)在心(xin)(xin)(xin)胸(xiong)(xiong)(xiong)外(wai)科開展的(de)代(dai)表(biao)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)。臨(lin)床(chuang)應用(yong)表(biao)明手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)機器人(ren)(ren)的(de)手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)安全性(xing)(xing)高(gao)，療效明顯好于(yu)(yu)開放(fang)式手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)和(he)胸(xiong)(xiong)(xiong)腔(qiang)鏡手(shou)(shou)(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)。

婦 科

以(yi)(yi)腹腔鏡技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)為代(dai)表(biao)的(de)(de)(de)(de)(de)微創手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)方式正逐步(bu)取(qu)代(dai)傳統的(de)(de)(de)(de)(de)開放式手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)，應(ying)用(yong)(yong)(yong)(yong)于(yu)(yu)(yu)(yu)從卵巢(chao)囊腫開窗引流(liu)到全子(zi)宮(gong)切除(chu)、盆腔淋巴結(jie)清(qing)掃的(de)(de)(de)(de)(de)各種(zhong)婦科(ke)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)中(zhong)。但是大部分(fen)的(de)(de)(de)(de)(de)婦科(ke)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)需(xu)要(yao)(yao)在狹窄的(de)(de)(de)(de)(de)盆腔內完成，手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)操(cao)作的(de)(de)(de)(de)(de)視野(ye)和空間都非(fei)常有(you)限，這(zhe)使(shi)腹腔鏡器械的(de)(de)(de)(de)(de)活(huo)動(dong)自由(you)度(du)(du)受限，且(qie)操(cao)作的(de)(de)(de)(de)(de)動(dong)作幅度(du)(du)不(bu)穩定，難以(yi)(yi)完成一些(xie)需(xu)要(yao)(yao)精(jing)(jing)細分(fen)離、縫合(he)(he)(he)及(ji)淋巴結(jie)清(qing)掃的(de)(de)(de)(de)(de)操(cao)作，限制(zhi)了腹腔鏡技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)在復(fu)雜(za)(za)婦科(ke)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)中(zhong)的(de)(de)(de)(de)(de)應(ying)用(yong)(yong)(yong)(yong)。達芬奇手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)機器人于(yu)(yu)(yu)(yu)2005年被美(mei)國(guo)FDA批準用(yong)(yong)(yong)(yong)于(yu)(yu)(yu)(yu)婦科(ke)微創手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)，此(ci)后，該技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)迅(xun)速普及(ji)。臨床應(ying)用(yong)(yong)(yong)(yong)結(jie)果表(biao)明(ming)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)機器人手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)具有(you)更高的(de)(de)(de)(de)(de)精(jing)(jing)確性、更好(hao)的(de)(de)(de)(de)(de)操(cao)控性，能在骨盆中(zhong)完成精(jing)(jing)細的(de)(de)(de)(de)(de)操(cao)作，有(you)利于(yu)(yu)(yu)(yu)功能的(de)(de)(de)(de)(de)重建和盆腔淋巴結(jie)清(qing)掃。國(guo)外報道較(jiao)多(duo)的(de)(de)(de)(de)(de)是用(yong)(yong)(yong)(yong)于(yu)(yu)(yu)(yu)宮(gong)頸癌根治手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)，該手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)需(xu)要(yao)(yao)運用(yong)(yong)(yong)(yong)精(jing)(jing)確的(de)(de)(de)(de)(de)分(fen)離技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)進(jin)行(xing)(xing)韌(ren)帶切斷、輸尿管(guan)游離、淋巴結(jie)清(qing)掃等，可以(yi)(yi)充分(fen)發(fa)揮手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)機器人的(de)(de)(de)(de)(de)技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)優勢，達到理(li)想的(de)(de)(de)(de)(de)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)效果。對于(yu)(yu)(yu)(yu)需(xu)要(yao)(yao)進(jin)行(xing)(xing)比較(jiao)復(fu)雜(za)(za)縫合(he)(he)(he)技(ji)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)的(de)(de)(de)(de)(de)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)，如復(fu)雜(za)(za)的(de)(de)(de)(de)(de)子(zi)宮(gong)肌瘤切除(chu)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)，運用(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)機器人靈巧的(de)(de)(de)(de)(de)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)臂高質量(liang)地完成縫合(he)(he)(he)，有(you)助于(yu)(yu)(yu)(yu)減(jian)少術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)后并發(fa)癥(zheng)的(de)(de)(de)(de)(de)發(fa)生。此(ci)外，報道的(de)(de)(de)(de)(de)手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)機器人手(shou)(shou)(shou)(shou)術(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)(shu)還有(you)全子(zi)宮(gong)切除(chu)、輸卵管(guan)再通吻合(he)(he)(he)、卵巢(chao)切除(chu)和盆底重建等。

腹部外科

早期手(shou)(shou)(shou)術(shu)(shu)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)主要用(yong)(yong)于(yu)腹部外(wai)(wai)科，開(kai)展了一些比較簡(jian)單的手(shou)(shou)(shou)術(shu)(shu)，但(dan)并(bing)沒有(you)表現(xian)出比腹腔(qiang)(qiang)鏡(jing)(jing)手(shou)(shou)(shou)術(shu)(shu)更明顯(xian)的優(you)勢，因而未推(tui)廣應用(yong)(yong)。近年來，隨著手(shou)(shou)(shou)術(shu)(shu)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)在(zai)其(qi)(qi)它(ta)外(wai)(wai)科領域的成功開(kai)展，其(qi)(qi)在(zai)腹部外(wai)(wai)科的應用(yong)(yong)和研究又重(zhong)新活躍，迅(xun)速開(kai)展了各(ge)種手(shou)(shou)(shou)術(shu)(shu)。根(gen)據其(qi)(qi)對第二(er)代(dai)腹腔(qiang)(qiang)鏡(jing)(jing)手(shou)(shou)(shou)術(shu)(shu)的影(ying)響程度，可(ke)將手(shou)(shou)(shou)術(shu)(shu)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)腹部外(wai)(wai)科手(shou)(shou)(shou)術(shu)(shu)分(fen)為三類：①對常規開(kai)展的腹腔(qiang)(qiang)鏡(jing)(jing)手(shou)(shou)(shou)術(shu)(shu)基本(ben)沒有(you)影(ying)響的機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)手(shou)(shou)(shou)術(shu)(shu)，例(li)如(ru)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)膽囊切(qie)(qie)除(chu)(chu)(chu)、抗(kang)反(fan)流的胃(wei)底折(zhe)疊、疝修補(bu)、闌尾切(qie)(qie)除(chu)(chu)(chu)、可(ke)調節捆(kun)扎帶(dai)胃(wei)減(jian)容(rong)和良性胃(wei)腸腫(zhong)瘤的切(qie)(qie)除(chu)(chu)(chu)等。②可(ke)顯(xian)著提高(gao)腹腔(qiang)(qiang)鏡(jing)(jing)手(shou)(shou)(shou)術(shu)(shu)效果的機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)手(shou)(shou)(shou)術(shu)(shu)，范(fan)圍(wei)比較廣泛，包括(kuo)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)肝葉切(qie)(qie)除(chu)(chu)(chu)、復(fu)雜(za)膽道重(zhong)建(jian)、胃(wei)旁路減(jian)重(zhong)、胃(wei)癌根(gen)治、結直腸癌根(gen)治、胰(yi)腺部分(fen)切(qie)(qie)除(chu)(chu)(chu)和胰(yi)十二(er)指腸切(qie)(qie)除(chu)(chu)(chu)等。③目前在(zai)腹腔(qiang)(qiang)鏡(jing)(jing)下難以完成，唯有(you)手(shou)(shou)(shou)術(shu)(shu)機(ji)(ji)(ji)器(qi)(qi)(qi)人(ren)(ren)能精準(zhun)完成的一些手(shou)(shou)(shou)術(shu)(shu)，例(li)如(ru)內臟動脈瘤切(qie)(qie)除(chu)(chu)(chu)吻合、細口徑的膽管空場吻合、復(fu)雜(za)的腹腔(qiang)(qiang)內淋巴結清掃等。

優勢

達芬奇(qi)手術(shu)機(ji)器人(ren)的具體優(you)勢可(ke)以從兩個(ge)方(fang)面(mian)說起：

第一：從患者角度(du)：

(1)手術操作更精確，與腹(fu)腔鏡(jing)(二維(wei)視(shi)覺(jue))相比，因(yin)三維(wei)視(shi)覺(jue)可放大(da)(da)10-15倍，使手術精確度大(da)(da)大(da)(da)增加，術后恢復快(kuai)，愈合好。

(2)曲線較腹腔鏡短。

(3)創傷更小使微創手術(shu)指征更廣;減(jian)少術(shu)后疼痛;縮短住(zhu)院時間;減(jian)少失血量;減(jian)少術(shu)中的(de)組織創傷和炎性反應導致的(de)術(shu)后粘(zhan)連;增加(jia)美容效果;更快投入工作。

第(di)二，從(cong)醫生(sheng)角度：

達芬奇手(shou)(shou)術機(ji)器(qi)人(ren)增加視野(ye)角(jiao)度;減少(shao)手(shou)(shou)部顫動，機(ji)器(qi)人(ren)“內腕”較(jiao)(jiao)腹腔鏡(jing)更為靈(ling)活，能以不同角(jiao)度在靶器(qi)官周圍操作(zuo);較(jiao)(jiao)人(ren)手(shou)(shou)小，能夠在有(you)限狹窄空間工作(zuo);使(shi)術者(zhe)在輕(qing)松工作(zuo)環境工作(zuo)，減少(shao)疲勞更集中精力;減少(shao)參加手(shou)(shou)術人(ren)員。

醫生(sheng)有利之處(chu)歸根到底(di)還是為患者(zhe)。例如(ru)，機(ji)器人提高精確(que)度，便能(neng)節省出手術(shu)(shu)時間(jian)從(cong)而(er)減少術(shu)(shu)者(zhe)疲勞，這樣可以進(jin)一步防止術(shu)(shu)者(zhe)手部顫動使術(shu)(shu)者(zhe)精力更集中(zhong)，使手術(shu)(shu)更完美。