心脏手术中的机器人革命。

IF 3 3区 医学 Q2 SURGERY
Jack Ng Kok Wah
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引用次数: 0

摘要

机器人辅助心脏手术(RACS)通过技术精度、微创技术和改善的临床结果,正在彻底改变心血管干预的前景。尽管其发展迅速,但在标准化、成本效益、外科医生学习曲线和以患者为中心的结果方面仍存在显著差距。该研究严格审查了当前的创新,评估了比较临床和经济影响,并综合了26项最新研究的主要趋势和矛盾。目的是评估RACS在不同手术中的临床疗效、可扩展性和系统意义,如二尖瓣修复、冠状动脉旁路移植术、新兴的机器人心脏和先天性手术。该综述采用混合方法,包括对患者经历的定性分析和对国家数据库和长期结果的定量评估,将系统综述、案例研究和荟萃分析整合在一起,以进行全面的比较综合。研究结果强调,与传统手术相比,RACS的围手术期结果更好,恢复更快,并发症发生率更低。机器人熟练程度与手术量、机构基础设施和跨学科培训密切相关,而经济评估仍然好坏参半,表明前期成本较高,但潜在的长期节省。值得注意的是,由于侵入性降低和康复速度加快,患者满意度一直很高,但对可及性和医疗公平的担忧仍然存在。矛盾的证据围绕着小容量中心的成本效益平衡和患者复杂性对学习曲线的影响,尽管新出现的证据表明,随着经验和技术的改进,这些因素正变得不那么令人难以接受。该综述指出了在多中心纵向研究、标准培训框架和临床工作流程中机器人物联网(IoRT)集成方面的差距。它建议扩大全球数据共享平台,完善机器人手术课程,并加强人工智能驱动的精确指导支持系统。其影响涉及患者护理质量、外科教育、医疗保健经济学和未来机器人创新。局限性包括潜在的发表偏倚和低资源环境的代表性不足。未来的研究应该集中在纵向的、多中心的试验上,评估机器人在不同人口统计学、程序和医疗基础设施中的结果。总之,心脏手术中的机器人革命有望带来革命性的进步,但需要全球协调一致的努力来弥合差距,优化训练,并验证其在复杂心血管护理中的长期价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The robotic revolution in cardiac surgery.

Robotic-assisted cardiac surgery (RACS) is revolutionizing the landscape of cardiovascular interventions through technological precision, minimally invasive techniques, and improved clinical outcomes. Despite its rapid expansion, significant gaps remain regarding standardization, cost-efficiency, surgeon learning curves, and patient-centered outcomes. The study critically examines current innovations, evaluates comparative clinical and economic impacts, and synthesizes key trends and contradictions from 26 recent studies. The objective is to assess the clinical efficacy, scalability, and systemic implications of RACS across diverse procedures, such as mitral valve repair, coronary artery bypass grafting, and emerging robotic heart and congenital surgeries. Employing a mixed-methods approach, including qualitative analysis of patient experiences and quantitative evaluation of national databases and long-term outcomes, the review integrates systematic reviews, case studies, and meta-analyses for a comprehensive comparative synthesis. Findings highlight superior perioperative outcomes, faster recovery, and reduced complication rates in RACS compared to the conventional surgery. Robotic proficiency correlates strongly with surgical volume, institutional infrastructure, and interdisciplinary training, while economic evaluations remain mixed, indicating higher upfront costs but potential long-term savings. Notably, patient satisfaction is consistently high due to reduced invasiveness and faster rehabilitation yet concerns about accessibility and healthcare equity persist. Contradictory evidence surrounds the cost-benefit balance in low-volume centers and the influence of patient complexity on the learning curve, although emerging evidence suggests that these factors are becoming less prohibitive with experience and technological refinement. The review identifies gaps in multicenter longitudinal studies, standard training frameworks, and integration of Internet of Robotic Things (IoRT) in clinical workflows. It recommends expanding global data-sharing platforms, refining robotic surgical curricula, and enhancing AI-driven support systems for precision guidance. The implications span patient care quality, surgical education, healthcare economics, and future robotic innovations. Limitations include potential publication bias and underrepresentation of low-resource settings. Future research should focus on longitudinal, multicentric trials evaluating robotic outcomes across different demographics, procedures, and healthcare infrastructures. In conclusion, the robotic revolution in cardiac surgery promises transformative advances, yet requires coordinated global efforts to bridge disparities, optimize training, and validate its long-term value in complex cardiovascular care.

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来源期刊
CiteScore
4.20
自引率
8.70%
发文量
145
期刊介绍: The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.
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