Download PDF
Viszeralchirurgie 2006; 41(3): 145-152
DOI: 10.1055/s-2006-933431
Aktuelle Chirurgie

© Georg Thieme Verlag Stuttgart · New York

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

Computer- and Robot-Assisted Abdominal Surgery - State of the Art and OutlookS. Beller1 , M. Hünerbein1 , P. M. Schlag1
  • 1Charité Universitätsmedizin Berlin, Robert Rössle Klinik im HELIOS Klinikum Berlin-Buch, Campus Berlin-Buch, Berlin
Further Information

Publication History

Publication Date:
20 June 2006 (online)

    Permissions and Reprints

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.

Schlüsselwörter

Abdomen - Chirurgie - Computer - Robotik - Telechirurgie

Key words

Abdominal - surgery - computer - robotic - telesurgery

Literatur

  • 1 Lang H, Radtke A, Hindennach M. et al . Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection.  Arch Surg. 2005;  140 629-638
    CrossrefPubMedGoogle Scholar
  • 2 Marescaux J, Clement J M, Tassetti V. et al . Virtual reality applied to hepatic surgery simulation: the next revolution.  Ann Surg. 1998;  228 627-634
    CrossrefPubMedGoogle Scholar
  • 3 Grunert P, Darabi K, Espinosa J. et al . Computer-aided navigation in neurosurgery.  Neurosurg Rev. 2003;  26 73-99
    CrossrefPubMedGoogle Scholar
  • 4 Gebhard F, Weidner A, Liener U C. et al . Navigation at the spine.  Injury. 2004;  35 (Suppl 1) S35-S45
    PubMedGoogle Scholar
  • 5 Siebel T, Kafer W. Modification of the posterior cruciate ligament tension following total knee arthroplasty: comparison of the Genesis CR and LCS meniscal bearing prostheses.  Knee. 2004;  11 203-208
    CrossrefPubMedGoogle Scholar
  • 6 Siebert W, Mai S, Kober R. et al . Technique and first clinical results of robot-assisted total knee replacement.  Knee. 2002;  9 173-180
    CrossrefPubMedGoogle Scholar
  • 7 Mazoochian F, Pellengahr C, Huber A. et al . Low accuracy of stem implantation in THR using the CASPAR-system: anteversion measurements in 10 hips.  Acta Orthop Scand. 2004;  75 261-264
    PubMedGoogle Scholar
  • 8 Wu L D, Hahne H J, Hassenpflug J. The dimensional accuracy of preparation of femoral cavity in cementless total hip arthroplasty.  J Zhejiang Univ Sci. 2004;  5 1270-1278
    CrossrefPubMedGoogle Scholar
  • 9 Schneider J, Kalender W. Geometric accuracy in robot-assisted total hip replacement surgery.  Comput Aided Surg. 2003;  8 135-145
    CrossrefPubMedGoogle Scholar
  • 10 Omote K, Feussner H, Ungeheuer A. et al . Self-guided robotic camera control for laparoscopic surgery compared with human camera control.  Am J Surg. 1999;  177 321-324
    CrossrefPubMedGoogle Scholar
  • 11 Satava R. Robotics, telepresence and virtual reality: a critical analysis of the future of surgery.  Min Invasiv Ther. 1992;  1 11-16
    PubMedGoogle Scholar
  • 12 Marescaux J, Leroy J, Rubino F. et al . Transcontinental robot-assisted remote telesurgery: feasibility and potential applications.  Ann Surg. 2002;  235 487-492
    CrossrefPubMedGoogle Scholar
  • 13 Senapati S, Advincula A P. Telemedicine and robotics: Paving the way to the globalization of surgery.  Int J Gynaecol Obstet. 2005;  91 210-216
    CrossrefPubMedGoogle Scholar
  • 14 Gandsas A, McIntire K, Montgomery K. et al . The personal digital assistant (PDA) as a tool for telementoring endoscopic procedures.  Stud Health Technol Inform. 2004;  98 99-103
    PubMedGoogle Scholar
  • 15 Jaspers J E, Breedveld P, Herder J L. et al . Camera and instrument holders and their clinical value in minimally invasive surgery.  Surg Laparosc Endosc Percutan Tech. 2004;  14 145-152
    PubMedGoogle Scholar
  • 16 Jaspers J E, Breedveld P, Herder J L. et al . Camera and instrument holders and their clinical value in minimally invasive surgery.  Surg Laparosc Endosc Percutan Tech. 2004;  14 145-152
    PubMedGoogle Scholar
  • 17 Moorthy K, Munz Y, Dosis A. et al . Dexterity enhancement with robotic surgery.  Surg Endosc. 2004;  18 790-795
    PubMedGoogle Scholar
  • 18 Verner L, Oleynikov D, Holtmann S. et al . Measurements of the level of surgical expertise using flight path analysis from da Vinci robotic surgical system.  Stud Health Technol Inform. 2003;  94 373-378
    PubMedGoogle Scholar
  • 19 Niemeyer G, Kuchenbecker K J, Bonneau R. et al . THUMP: an immersive haptic console for surgical simulation and training.  Stud Health Technol Inform. 2004;  98 272-274
    PubMedGoogle Scholar
  • 20 Chitwood Jr  W R, Nifong L W, Chapman W H. et al . Robotic surgical training in an academic institution.  Ann Surg. 2001;  234 475-484
    CrossrefPubMedGoogle Scholar
  • 21 Marvik R, Lango T, Tangen G A. et al . Laparoscopic navigation pointer for three-dimensional image-guided surgery.  Surg Endosc. 2004;  18 1242-1248
    CrossrefPubMedGoogle Scholar
  • 22 Lang H, Radtke A, Hindennach M. et al . Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection.  Arch Surg. 2005;  140 629-638
    CrossrefPubMedGoogle Scholar
  • 23 Hildebrandt U, Plusczyk T, Kessler K. et al . Single-surgeon surgery in laparoscopic colonic resection.  Dis Colon Rectum. 2003;  46 1640-1645
    PubMedGoogle Scholar
  • 24 Kraft B M, Jager C, Kraft K. et al . The AESOP robot system in laparoscopic surgery: increased risk or advantage for surgeon and patient?.  Surg Endosc. 2004;  18 1216-1223
    CrossrefPubMedGoogle Scholar
  • 25 Bonatti J, Schachner T, Bonaros N. et al . Ongoing procedure development in Robotically Assisted Totally Endoscopic Coronary Artery Bypass Grafting (TECAB).  Heart Surg Forum. 2005;  8 E287-E291
    PubMedGoogle Scholar
  • 26 Jacobsen G, Elli F, Horgan S. Robotic surgery update.  Surg Endosc. 2004;  18 1186-1191
    CrossrefPubMedGoogle Scholar
  • 27 Cadiere G B, Himpens J, Vertruyen M. et al . Evaluation of telesurgical (robotic) NISSEN fundoplication.  Surg Endosc. 2001;  15 918-923
    CrossrefPubMedGoogle Scholar
  • 28 Drasin T, Dutson E, Gracia C. Use of a robotic system as surgical first assistant in advanced laparoscopic surgery.  J Am Coll Surg. 2004;  199 368-373
    CrossrefPubMedGoogle Scholar
  • 29 Costi R, Himpens J, Iusco D. et al . [Robotic fundoplication for gastro-oesophageal reflux disease].  Chir Ital. 2004;  56 321-331
    PubMedGoogle Scholar
  • 30 Muhlmann G, Klaus A, Kirchmayr W. et al . DaVinci robotic-assisted laparoscopic bariatric surgery: is it justified in a routine setting?.  Obes Surg. 2003;  13 848-854
    CrossrefPubMedGoogle Scholar
  • 31 Moser F, Horgan S. Robotically assisted bariatric surgery.  Am J Surg. 2004;  188 38-44
    CrossrefPubMedGoogle Scholar
  • 32 Miller D W, Schlinkert R T, Schlinkert D K. Robot-assisted laparoscopic cholecystectomy: initial Mayo Clinic Scottsdale experience.  Mayo Clin Proc. 2004;  79 1132-1136
    PubMedGoogle Scholar
  • 33 Bodner J, Hoeller E, Wykypiel H. et al . Long-term follow-up after robotic cholecystectomy.  Am Surg. 2005;  71 281-285
    PubMedGoogle Scholar
  • 34 Roeyen G, Chapelle T, Ysebaert D. Robot-assisted choledochotomy: feasibility.  Surg Endosc. 2004;  18 165-166
    PubMedGoogle Scholar
  • 35 Hourmont K, Chung W, Pereira S. et al . Robotic versus telerobotic laparoscopic cholecystectomy: duration of surgery and outcomes.  Surg Clin North Am. 2003;  83 1445-1462
    CrossrefPubMedGoogle Scholar
  • 36 Nio D, Bemelman W A, Busch O R. et al . Robot-assisted laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a comparative study.  Surg Endosc. 2004;  18 379-382
    CrossrefPubMedGoogle Scholar
  • 37 Zhou H X, Guo Y H, Yu X F. et al . Zeus robot-assisted laparoscopic cholecystectomy in comparison with conventional laparoscopic cholecystectomy.  Hepatobiliary Pancreat Dis Int. 2006;  5 115-118
    PubMedGoogle Scholar
  • 38 Horgan S, Berger R A, Elli E F. et al . Robotic-assisted minimally invasive transhiatal esophagectomy.  Am Surg. 2003;  69 624-626
    PubMedGoogle Scholar
  • 39 Elli E, Espat N J, Berger R. et al . Robotic-assisted thoracoscopic resection of esophageal leiomyoma.  Surg Endosc. 2004;  18 713-716
    CrossrefPubMedGoogle Scholar
  • 40 Kernstine K H, DeArmond D T, Karimi M. et al . The robotic, 2-stage, 3-field esophagolymphadenectomy.  J Thorac Cardiovasc Surg. 2004;  127 1847-1849
    CrossrefPubMedGoogle Scholar
  • 41 Ruurda J P, Draaisma W A, van Hillegersberg R. et al . Robot-assisted endoscopic surgery: a four-year single-center experience.  Dig Surg. 2005;  22 313-320
    PubMedGoogle Scholar
  • 42 Espat N J, Jacobsen G, Horgan S. et al . Minimally invasive treatment of esophageal cancer: laparoscopic staging to robotic esophagectomy.  Cancer J. 2005;  11 10-17
    PubMedGoogle Scholar
  • 43 Horgan S, Galvani C, Gorodner M V. et al . Robotic-assisted Heller myotomy versus laparoscopic Heller myotomy for the treatment of esophageal achalasia: multicenter study.  J Gastrointest Surg. 2005;  9 1020-1029
    CrossrefPubMedGoogle Scholar
  • 44 Weber P A, Merola S, Wasielewski A. et al . Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease.  Dis Colon Rectum. 2002;  45 1689-1694
    CrossrefPubMedGoogle Scholar
  • 45 Braumann C, Jacobi C A, Menenakos C. et al . Computer-assisted laparoscopic colon resection with the Da Vinci system: our first experiences.  Dis Colon Rectum. 2005;  48 1820-1827
    CrossrefPubMedGoogle Scholar
  • 46 Delaney C P, Lynch A C, Senagore A J. et al . Comparison of robotically performed and traditional laparoscopic colorectal surgery.  Dis Colon Rectum. 2003;  46 1633-1639
    CrossrefPubMedGoogle Scholar
  • 47 Munz Y, Moorthy K, Kudchadkar R. et al . Robotic assisted rectopexy.  Am J Surg. 2004;  187 88-92
    CrossrefPubMedGoogle Scholar
  • 48 Anvari M, Birch D W, Bamehriz F. et al . Robotic-assisted laparoscopic colorectal surgery.  Surg Laparosc Endosc Percutan Tech. 2004;  14 311-315
    CrossrefPubMedGoogle Scholar
  • 49 Moinzadeh A, Gill I S. Robotic adrenalectomy.  Urol Clin North Am. 2004;  31 753-756
    CrossrefPubMedGoogle Scholar
  • 50 Winter J M, Talamini M A, Stanfield C L. et al . Thirty robotic adrenalectomies: a single institution's experience.  Surg Endosc. 2005;  20 119-124
    PubMedGoogle Scholar
  • 51 Brunaud L, Bresler L, Zarnegar R. et al . Does robotic adrenalectomy improve patient quality of life when compared to laparoscopic adrenalectomy?.  World J Surg. 2004;  28 1180-1185
    CrossrefPubMedGoogle Scholar
  • 52 Morino M, Beninca G, Giraudo G. et al . Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial.  Surg Endosc. 2004;  18 1742-1746
    CrossrefPubMedGoogle Scholar
  • 53 Seelig M H, Senninger N, Kocher T. [Laparoscopic splenectomy: first experiences with a 3-trocar-technique and the ‘hanging-spleen-maneuver’].  Zentralbl Chir. 2004;  129 387-390
    Article in Thieme ConnectPubMedGoogle Scholar
  • 54 Bodner J, Kafka-Ritsch R, Lucciarini P. et al . A critical comparison of robotic versus conventional laparoscopic splenectomies.  World J Surg. 2005;  29 982-985
    CrossrefPubMedGoogle Scholar
  • 55 Melvin W S. Minimally invasive pancreatic surgery.  Am J Surg. 2003;  186 274-278
    CrossrefPubMedGoogle Scholar
  • 56 Kleemann M, Hildebrand P H, Mirow L. et al . Navigation in der Viszeralchirurgie.  Chir Gastroenterol. 2005;  21 (Suppl 2) 1-7
    PubMedGoogle Scholar
  • 57 Lange T, Eulenstein S, Hunerbein M. et al . Vessel-based non-rigid registration of MR/CT and 3D ultrasound for navigation in liver surgery.  Comput Aided Surg. 2003;  8 228-240
    PubMedGoogle Scholar
  • 58 Chitwood  Jr W R, Nifong L W, Chapman W H. et al . Robotic surgical training in an academic institution.  Ann Surg. 2001;  234 475-484
    CrossrefPubMedGoogle Scholar
  • 59 Melvin W S, Needleman B J, Krause K R. et al . Computer-enhanced vs. standard laparoscopic antireflux surgery.  J Gastrointest Surg. 2002;  6 11-15
    CrossrefPubMedGoogle Scholar
  • 60 Gutt C N, Markus B, Kim Z G. et al . Early experiences of robotic surgery in children.  Surg Endosc. 2002;  16 1083-1086
    CrossrefPubMedGoogle Scholar
  • 61 Talamini M, Campbell K, Stanfield C. Robotic gastrointestinal surgery: early experience and system description.  J Laparoendosc Adv Surg Tech A. 2002;  12 225-232
    CrossrefPubMedGoogle Scholar
  • 62 Beninca G, Garrone C, Rebecchi F. et al . [Robot-assisted laparoscopic surgery. Preliminary results at our Center].  Chir Ital. 2003;  55 321-331
    PubMedGoogle Scholar
  • 63 Bodner J, Wykypiel H, Wetscher G. et al . First experiences with the da Vinci operating robot in thoracic surgery.  Eur J Cardiothorac Surg. 2004;  25 844-851
    CrossrefPubMedGoogle Scholar
  • 64 Knight C G, Lorincz A, Gidell K M. et al . Computer-assisted robot-enhanced laparoscopic fundoplication in children.  J Pediatr Surg. 2004;  39 864-866
    CrossrefPubMedGoogle Scholar
  • 65 Ruurda J P, Gooszen H G, Broeders I A. Early experience in robot-assisted laparoscopic Heller myotomy.  Scand J Gastroenterol. 2004;  Suppl 4-8
    CrossrefPubMedGoogle Scholar
  • 66 Mohr C J, Nadzam G S, Curet M J. Totally robotic Roux-en-Y gastric bypass.  Arch Surg. 2005;  140 779-786
    PubMedGoogle Scholar
  • 67 Ali M R, Bhaskerrao B, Wolfe B M. Robot-assisted laparoscopic Roux-en-Y gastric bypass.  Surg Endosc. 2005;  19 468-472
    CrossrefPubMedGoogle Scholar
  • 68 Marescaux J, Smith M K, Folscher D. et al . Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients.  Ann Surg. 2001;  234 1-7
    CrossrefPubMedGoogle Scholar
  • 69 Ruurda J P, Broeders I A, Simmermacher R P. et al . Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies.  Surg Laparosc Endosc Percutan Tech. 2002;  12 41-45
    CrossrefPubMedGoogle Scholar
  • 70 Ruurda J P, Visser P L, Broeders I A. Analysis of procedure time in robot-assisted surgery: comparative study in laparoscopic cholecystectomy.  Comput Aided Surg. 2003;  8 24-29
    PubMedGoogle Scholar
  • 71 Talamini M A, Chapman S, Horgan S. et al . A prospective analysis of 211 robotic-assisted surgical procedures.  Surg Endosc. 2003;  17 1521-1524
    CrossrefPubMedGoogle Scholar
  • 72 Corcione F, Esposito C, Cuccurullo D. et al . Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience.  Surg Endosc. 2005;  19 117-119
    CrossrefPubMedGoogle Scholar
  • 73 Heemskerk J, van Dam R, van Gemert W G. et al . First results after introduction of the four-armed da Vinci surgical system in fully robotic laparoscopic cholecystectomy.  Dig Surg. 2006;  22 426-431
    PubMedGoogle Scholar
  • 74 Brunaud L, Bresler L, Ayav A. et al . [Advantages of using robotic Da Vinci system for unilateral adrenalectomy: early results].  Ann Chir. 2003;  128 530-535
    CrossrefPubMedGoogle Scholar
  • 75 Brunaud L, Bresler L, Zarnegar R. et al . Does robotic adrenalectomy improve patient quality of life when compared to laparoscopic adrenalectomy?.  World J Surg. 2004;  28 1180-1185
    CrossrefPubMedGoogle Scholar
  • 76 Winter J M, Talamini M A, Stanfield C L. et al . Thirty robotic adrenalectomies: a single institution's experience.  Surg Endosc. 2006;  20 119-124
    CrossrefPubMedGoogle Scholar

Prof. Dr. Dr. h. c. Peter Michael Schlag

Klinik für Chirurgie und Chirurgische Onkologie · Charitè Campus Buch

Lindenberger Weg 80

13125 Berlin

Email: pmschlag@charite.de