机器人辅助输尿管软镜手术系统的研究现状和未来发展方向

高小峰; 方梓宇

doi:10.13201/j.issn.1001-1420.2023.06.001

机器人辅助输尿管软镜手术系统的研究现状和未来发展方向

高小峰^1, ,,
方梓宇¹

- 海军军医大学第一附属医院(上海长海医院)泌尿外科(上海，200433)

详细信息

作者简介:
高小峰，现任海军军医大学第一附属医院(上海长海医院)泌尿外科教授，主任医师，博士生导师。中华医学会泌尿外科分会委员、中华医学会泌尿外科分会尿路结石学组副组长，上海市医学会泌尿外科分会秘书长、常委兼尿路结石学组组长，中央军委保健委员会会诊专家，担任《中华泌尿外科杂志》等杂志编委。擅长泌尿系结石、前列腺增生的微创治疗。国内率先开展输尿管软镜碎石术和超声引导经皮肾镜取石术；提出“两点两线一面”的前列腺激光剜除技术，降低术后尿失禁的发生率。发表论文60余篇，主编和副主编专著7部，授权国家发明专利5项。作为项目负责人，获得包括国家自然科学基金在内的省部级课题10余项，先后获国家科技进步二等奖1项、上海市科技进步一等奖1项、军队医疗成果一等奖1项。荣获中华医学会泌尿外科分会结石领域专项奖——“钻石奖”、上海市卫生系统“银蛇奖”、上海市杰出青年医学人才、人民网“国之名医-优秀风范”等奖励和荣誉。主持科技部国家重点研发计划“经输尿管肾内介入诊疗机器人系统”，研发样机2台，并完成动物实验，效果良好

通讯作者: 高小峰，E-mail：gxfdoc@sina.com

中图分类号: R699

收稿日期: 2023-04-19

刊出日期: 2023-06-06

Research status and future development direction of robot-assisted flexible ureteroscopy system

GAO Xiaofeng^1, ,,
FANG Ziyu¹

- Department of Urology, Changhai Hospital, First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China

More Information

Corresponding author: GAO Xiaofeng, E-mail: gxfdoc@sina.com

Received Date: 19 April 2023

Publish Date: 06 June 2023

摘要

摘要: 近年来，随着内镜器械的发展，输尿管软镜成为治疗上尿路结石的主流手段。但是软镜手术在实际运用中存在诸多局限性，如控制难度大、定位精度及稳定性有待提高，且其操作方式容易导致术者疲劳，引发肌肉骨骼疾病。机器人辅助输尿管软镜手术系统有助于弥补传统操作的不足，扩展软镜手术的优势。其具有精度高、稳定性好、学习曲线短、符合人体工程学原理、减少射线暴露等优点；但仍需要进一步开展应用研究来评估该系统的价值。本文总结了机器人辅助输尿管软镜手术系统的研究现状，展望了未来可能的发展方向。
- 机器人手术 /
- 软性输尿管镜 /
- 机器人辅助输尿管软镜手术系统
Abstract: With the development of endoscopic technology, the flexible ureteroscopy (fURS) has become the mainstream in the treatment of nephrolithiasis in recent years. However, there are many limitations in the practical application of fURS. For example, its operation is relatively complex and the accuracy and stability of positioning need to be improved. Its operation method is easy to cause fatigue and musculoskeletal diseases for operators. Robot-assisted flexible ureteroscopy systems help to compensate for traditional procedures and extend the advantages of fURS. It has the advantages of high precision, good stability, short learning curve, optimized ergonomic results, and less X-ray radiation. However, further applied research is needed to assess the value of the system. This article summarizes the research status and future directions of robot-assisted flexible ureteroscopy systems.
- robotic surgical procedures /
- flexible ureteroscope /
- robot-assisted flexible ureteroscopy system

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图 1 国产机器人辅助软性输尿管软镜手术系统样机

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图 2 使用国产机器人辅助软性输尿管镜手术系统进行猪动物手术

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参考文献(24)

[1]	Rassweiler JJ, Teber D. Advances in laparoscopic surgery in urology[J]. Nat Rev Urol, 2016, 13(7): 387-399. doi: 10.1038/nrurol.2016.70
[2]	Rassweiler JJ, Goezen AS, Rassweiler-Seyfried MC, et al. Robots in urology-an analysis of current and future devices[J]. Urologe A, 2018, 57(9): 1075-1090. doi: 10.1007/s00120-018-0733-0
[3]	Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy[J]. BJU Int, 2001, 87(4): 408-410. doi: 10.1046/j.1464-410x.2001.00115.x
[4]	Rassweiler J, Frede T, Seemann O, et al. Telesurgical laparoscopic radical prostatectomy. Initial experience[J]. Eur Urol, 2001, 40(1): 75-83. doi: 10.1159/000049752
[5]	Desai MM, Aron M, Gill IS, et al. Flexible robotic retrograde renoscopy: description of novel robotic device and preliminary laboratory experience[J]. Urology, 2008, 72(1): 42-46. doi: 10.1016/j.urology.2008.01.076
[6]	Desai MM, Grover R, Aron M, et al. Robotic flexible ureteroscopy for renal calculi: initial clinical experience[J]. J Urol, 2011, 186(2): 563-568. doi: 10.1016/j.juro.2011.03.128
[7]	Matlaga BR. Robotic flexible ureteroscopy[J]. J Urol, 2011, 186(2): 569. doi: 10.1016/j.juro.2011.05.015
[8]	Dahm P, Sedrakyan A, McCulloch P. Application of the IDEAL framework to robotic urologic surgery[J]. Eur Urol, 2014, 65(5): 849-851. doi: 10.1016/j.eururo.2013.11.003
[9]	Saglam R, Muslumanoglu AY, Tokatlı Z, et al. A new robot for flexible ureteroscopy: development and early clinical results(IDEAL stage 1-2b)[J]. Eur Urol, 2014, 66(6): 1092-1100. doi: 10.1016/j.eururo.2014.06.047
[10]	Geavlete P, Saglam R, Georgescu D, et al. Robotic Flexible Ureteroscopy Versus Classic Flexible Ureteroscopy in Renal Stones: the Initial Romanian Experience[J]. Chirurgia(Bucur), 2016, 111(4): 326-329. http://www.revistachirurgia.ro/pdfs/2016-4-326.pdf
[11]	Rassweiler J, Fiedler M, Charalampogiannis N, et al. Robot-assisted flexible ureteroscopy: an update[J]. Urolithiasis, 2018, 46(1): 69-77. doi: 10.1007/s00240-017-1024-8
[12]	Talari HF, Monfaredi R, Wilson E, et al. Robotically assisted ureteroscopy for kidney exploration[J]. Proc SPIE Int Soc Opt Eng, 2017, 10135: 1013512.
[13]	李昕. 输尿管软镜机器人的研发与应用[J]. 医学与哲学, 2016, 37(16): 11-12, 32. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL201608005.htm
[14]	崔亮, 李建民, 殷小涛, 等. 机器人辅助输尿管软镜手术系统的研制及试验评价[J]. 临床泌尿外科杂志, 2018, 33(7): 511-515. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW201807003.htm
[15]	Zhao J, Li J, Cui L, et al. Design and Performance Investigation of a Robot-Assisted Flexible Ureteroscopy System[J]. Appl Bionics Biomech, 2021, 2021: 6911202. http://www.socolar.com/Article/Index?aid=100091597179&jid=100000008921
[16]	李凌, 王则宇, 董浩, 等. 机器人辅助软性输尿管镜手术系统的体外性能评价和动物体内手术应用研究[J]. 中华泌尿外科杂志, 2022, 43(8): 607-613. doi: 10.3760/cma.j.cn112330-20210210-00087
[17]	Rassweiler-Seyfried MC, Herrmann J, Klein J, et al. Robot-assisted flexible ureterorenoscopy: state of the art in 2022[J]. Mini-invasive Surgery, 2022, 6: 41. doi: 10.20517/2574-1225.2022.41
[18]	Shu X, Chen Q, Xie L. A novel robotic system for flexible ureteroscopy[J]. Int J Med Robot, 2021, 17(1): 1-11.
[19]	宣寒青, 徐云泽, 陈奇, 等. 新型经输尿管肾内介入诊疗机器人系统的研发及试验评价[J]. 临床泌尿外科杂志, 2021, 36(9): 721-724. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202109009.htm
[20]	Gauhar V, Traxer O, Cho SY, et al. Robotic Retrograde Intrarenal Surgery: A Journey from "Back to the Future"[J]. J Clin Med, 2022, 11(18): 5488.
[21]	Han H, Kim J, Moon YJ, et al. Feasibility of Laser Lithotripsy for Midsize Stones Using Robotic Retrograde Intrarenal Surgery System easyUretero in a Porcine Model[J]. J Endourol, 2022, 36(12): 1586-1592. http://pubmed.ncbi.nlm.nih.gov/35850514/
[22]	Lee JY, Jeon SH. Robotic flexible ureteroscopy: A new challenge in endourology[J]. Investig Clin Urol, 2022, 63(5): 483-485.
[23]	Murgu SD. Robotic assisted-bronchoscopy: technical tips and lessons learned from the initial experience with sampling peripheral lung lesions[J]. BMC Pulm Med, 2019, 19(1): 89. http://doc.paperpass.com/foreign/rgArti2019221716405.html
[24]	Ethicon's MONARCH^® Endoscopic Robotic Platform Receives FDA 510(k)Clearance for Urology Procedures[OL]. [2023-02-07]. https://www.jnjmedtech.com/en-US/news-events/ethicon/Monarch-Platform-Urology-human-kidney-stone-removal.