In the eyes of ordinary people, scenes such as robotic surgery exist only in science fiction movies. In fact, surgical robots have been in the clinic for 16 years, and its emergence has brought surgical minimally invasive surgery into a new era. In order to uncover the mystery of the surgical robot, on March 9th, the reporter followed the professor of the Department of Hepatobiliary Surgery, Peking University People's Hospital, Zhu Jiye, into the operating room to observe an advanced robotic operation.
Zhu Jiye, Professor, Chief Physician, Doctoral Supervisor, Director of Hepatobiliary Surgery, Peking University People's Hospital, Director of General Surgery Department of Peking University International Hospital and Director of Hepatobiliary Surgery.
In the operating room, the first thing that enters the reporter's line of sight is a large group of machines, divided into three parts: the doctor's console, the bedside robotic arm system, and the imaging system. The robot, called Da Vinci, is not a real robot. They can't perform their own surgery. They still need surgeons to manipulate them and input commands. The doctor's console is kept away from the sterile area where the patient is located. The surgeon uses a pair of hands and feet to control the instrument and the high-definition camera to complete a series of surgical operations. The bedside robot system is located at the patient's bedside. The four robotic arms of Da Vinci are drilled into the patient through four small soybean-sized holes. The main responsibility is to replace the surgical instruments and camera lens with the assistant to assist the surgeon to complete the operation. Only a few minimally invasive small incisions will be left on the skin after surgery. The imaging system is a high-resolution 3D lens with a magnification of more than 10 times, providing the operator with a clearer and more precise view than open surgery. Later, during the entire operation, the surgeon was sitting on the console, just like manipulating a 3D game console. The hands did not touch the patient at all, and even completed the "pretty" operation without seeing the patient.
According to Professor Zhu Jiye, the concept of minimally invasive surgery is often limited to "cavitoscope" technology, and the advent of Da Vinci surgical robots further broadens the scope of minimally invasive surgery, representing the highest technology and cutting edge of modern minimally invasive surgery. Level. Since the introduction of China's first Da Vinci surgical robot in the General Hospital of the People's Liberation Army in 2006, its development in China has been very rapid. According to the latest data, as of the end of 2015, 42 Da Vinci surgical robots have been put into use in China (excluding Hong Kong, Macao and Taiwan), and three large local general hospitals including Peking University People’s Hospital have been installed in Beijing. . Da Vinci robots can be used in general surgery, urology, cardiac surgery, thoracic surgery, gynecology and many other fields. Almost all operations that can be done with minimally invasive techniques (endoscopic) can be completed. Currently, it has been completed in China. More than 22,000 operations, of which only 11,000 were completed in 2015, which is equivalent to the sum of all Da Vinci robotic operations in previous years. In addition to surgical robots, medical robots such as rehabilitation robots, service robots, and smart devices are gradually entering people's lives.
The biggest feature of the surgical robot is the precise operation. The surgical instrument is more flexible than the human finger. It can even easily pick up a fine hair on the gauze. Plus the stabilizer on the robot arm can filter out the surgeon's hand when the knife is involuntarily. Quivering, avoiding accidents. The use of the robot not only extends the doctor's eyes and hands, but also sees places that were previously invisible, enters areas that were previously inaccessible, and brings the benefits of less trauma, less bleeding, and less pain to the patient; The average hospital stay was cut in half compared with the traditional surgery, and the postoperative survival rate and recovery rate were greatly improved.
Although robotic surgery has many advantages, there are still some areas for improvement. Due to the lack of tactile feedback in the robot system itself, the surgeon cannot control and evaluate the lesion texture by the feel of the open surgery. At the same time, the surgeon cannot perceive the machinery. The strength of the arm may result in excessive or insufficient knotting. It is also very important that robotic surgery is very demanding on the surgeon and requires rigorous training and assessment. In addition, due to the high cost of machinery and equipment, the cost of surgery is tens of thousands more than the cost of traditional open surgery, which limits the promotion of robotic surgery in China in the short term. Despite this, Professor Zhu Jiye is very optimistic about the prospects of robotic surgery. "Like laparoscopic surgery, from the beginning of the few people to the current popularity, the threshold of price cost, patent technology, etc. will progress with technology. The scale effect is gradually decreasing, and more and more patients will enjoy the great benefits brought by robotic surgery."
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