Computer- und Roboter-assistierte Viszeralchirurgie - Status quo und Perspektive

Zusammenfassung

Die Computer- und Roboter-assistierte Chirurgie hat sich bisher besonders in der Neurochirurgie und Orthopädie etabliert. Anwendung finden Planungs- und Visualisierungstools, Orientierungshilfen durch chirurgische Navigationstechnologien, sowie Bewegungsautomaten und telechirurgische Systeme. Vorteile ergeben sich vor allem durch eine Erweiterung der visuellen Wahrnehmung, sowie durch eine bessere anatomische Orientierung. Eine Unterstützung des chirurgischen Geschicks ist möglich durch Steigerung der Präzision. Weitere Vorteile ergeben sich für die Ausbildung in der Chirurgie sowie für die Analyse und Dokumentation chirurgischer Manipulationen. In der Viszeralchirurgie hat sich vor allem die 3D-Simulation in der Leberchirurgie etabliert. Die Anwendung und Wertigkeit von Kameraführungssystemen und telechirurgischen Systemen in der Viszeralchirurgie wird anhand der aktuellen Literatur und den eigenen Erfahrungen erörtert. Vielversprechend erweist sich bisher die Computerassistenz in der Leberchirurgie, sowie telechirurgische Techniken bei komplexen laparoskopischen Eingriffen unter eingeengten Raumverhältnissen. Mit zunehmender Weiterentwicklung minimalinvasiver Verfahren werden die Perspektiven für die Computer- und Robotertechnologie in der Viszeralchirurgie steigen.

Abstract

Computer- and Robot-assistance is mainly used in neurosurgery and orthopaedics. Tools for surgical planning and visualisation, navigational systems, as well as action automatation and telesurgical systems are available. These systems support surgical skill by enhanced visual perception, improved anatomical orientation and high precision. There are also potential benefits for surgical education, as well as evaluation and documentation of surgical manipulation. In abdominal surgery 3D-simulation has proved of value in liver surgery. The practice and impact of telesurgical systems and devices for camera guidance are argued on the basis of reports from literature and own experience. Computer assistance is very helpful for major liver resections, while telesurgical techniques may allow to perform complex surgical manipulations in narrow anatomical spaces. With further development of minimally invasive procedures the impact of computer- and robot-technology will increase.

Abdomen - Chirurgie - Computer - Robotik - Telechirurgie

Abdominal - surgery - computer - robotic - telesurgery

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