PDF(Pubmed)
Abstract：
Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to report its usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases was conducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. The articles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was performed. Thirty-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) are encouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates were greater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition, robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encountered with traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy and microsurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. The current evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery to become incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systems are becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.
摘要：
机器人辅助手术是泌尿外科许多领域治疗的金标准。在这次系统审查中，我们的目标是报告其在男科的使用情况，并评估任何优势。对PubMed和CochraneLibrary数据库进行了系统搜索，以识别涉及男科机器人辅助显微外科的文章。搜索策略符合系统审查和荟萃分析（PRISMA）指南和Cochrane手册的首选报告项目。然后由两位作者审查了这些文章。对符合纳入标准的文章进行定性分析。审查了31篇符合纳入标准的文章。机器人辅助血管造口术（RAVV）的第一个结果令人鼓舞，因为它具有出色的通畅率，手术时间短，并实现了学习曲线。有趣的是,在某些病例系列中，RAVV的通畅率高于显微外科血管造口术，具有统计学上的显著差异。此外,机器人已被证明是非常有用的绕过纤维化变化的情况下，医源性血管损伤，传统显微外科手术遇到的困难。此外,机器人辅助显微手术的可行性已被证明用于精索静脉曲张切除术和精索显微手术去神经,精子参数和疼痛有可接受的改善，分别。目前的证据表明，在男科中使用机器人有潜在的优势。然而,机器人手术被纳入到男性医生的日常使用中，大,需要进行多中心随机试验.随着机器人系统成为泌尿外科实践的标准，人们相信他们也会在男科中找到自己的位置是合理的。
