机器人手术代表了外科手术的一个里程碑,提供诸如侵入性较小的方法等优点,消除震颤,缩放运动,和3D可视化。这种深入分析探讨了机器人方法的复杂生化影响。使用气腹和陡峭的Trendelenburg定位可以降低肺顺应性和内脏灌注,同时增加高碳酸血症。然而,机器人手术通过最小化组织创伤来减少手术压力和炎症。这有助于更快的恢复,但可能会限制免疫功能。与开放手术相比,机器人程序还限制了缺血再灌注损伤和氧化损伤。它们还有助于保持天然的抗氧化剂防御和凝结。在临床环境中,机器人程序减少失血,疼痛,并发症,以及与传统程序相比的停留时间。然而,风险依然存在,包括设备故障,需要转换为开放手术和增加的成本。在肿瘤学方面,关于利润率的争论仍然存在,复发,和长期生存。先进技术的出现,如术中生物传感器,局部给药系统,以及人工智能的合并,可以进一步提高机器人手术的效率。然而,关于患者同意的伦理困境,隐私,access,和监管这种破坏性的创新需要解决。总的来说,这篇综述揭示了机器人手术的复杂生化含义,并强调了需要额外机械研究的领域。它提出了一种全面的方法,以负责任地最大限度地发挥机器人手术的潜力,以改善患者的预后。将技术技能与对生理和道德问题的仔细考虑相结合。
Robotic surgery represents a milestone in surgical procedures, offering advantages such as less invasive methods, elimination of tremors, scaled motion, and 3D visualization. This in-depth analysis explores the complex biochemical effects of robotic methods. The use of pneumoperitoneum and steep Trendelenburg positioning can decrease pulmonary compliance and splanchnic perfusion while increasing hypercarbia. However, robotic surgery reduces surgical stress and inflammation by minimizing tissue trauma. This contributes to faster recovery but may limit immune function. Robotic procedures also limit ischemia-reperfusion injury and oxidative damage compared to open surgery. They also help preserve native antioxidant defenses and coagulation. In a clinical setting, robotic procedures reduce blood loss, pain, complications, and length of stay compared to traditional procedures. However, risks remain, including device failure, the need for conversion to open surgery and increased costs. On the oncology side, there is still debate about margins, recurrence, and long-term survival. The advent of advanced technologies, such as intraoperative biosensors, localized drug delivery systems, and the incorporation of artificial intelligence, may further improve the efficiency of robotic surgery. However, ethical dilemmas regarding patient consent, privacy, access, and regulation of this disruptive innovation need to be addressed. Overall, this review sheds light on the complex biochemical implications of robotic surgery and highlights areas that require additional mechanistic investigation. It presents a comprehensive approach to responsibly maximize the potential of robotic surgery to improve patient outcomes, integrating technical skill with careful consideration of physiological and ethical issues.