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中华腔镜外科杂志(电子版) ›› 2025, Vol. 18 ›› Issue (04) : 198 -202. doi: 10.3877/cma.j.issn.1674-6899.2025.04.002

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机器人胰腺手术5500例经验
刘荣(), 刘渠   
  1. 100853 北京,解放军总医院第一医学中心肝胆胰外科医学部
  • 收稿日期:2025-07-11 出版日期:2025-08-30
  • 通信作者: 刘荣

Experience with 5500 robitic pancreatic surgeries

Rong Liu(), Qu Liu   

  1. Faculty of Hepatobiliary and Pancreatic Surgery First Medical Center PLA General Hospital, Beijing 100853, China
  • Received:2025-07-11 Published:2025-08-30
  • Corresponding author: Rong Liu
引用本文:

刘荣, 刘渠. 机器人胰腺手术5500例经验[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(04): 198-202.

Rong Liu, Qu Liu. Experience with 5500 robitic pancreatic surgeries[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2025, 18(04): 198-202.

机器人手术在精细和复杂操作方面展现出明显优势,在泌尿外科、胃肠外科和妇产科的应用逐渐普及,然而在胰腺外科的发展相对缓慢。笔者团队2011年至2025年期间共完成5500例机器人胰腺手术,通过对上述手术经验的总结,笔者提出了新技术、新理念和新亚专科。其中,新技术包括模式化布孔、L孔R孔的应用、301胰肠吻合、上翻式胰体尾癌根治、荣式手术;新理念涵盖:环血管切除技术和低张力低应力吻合;新亚专科:胰管(修复)外科。上述经验和理念能够帮助机器人胰腺外科医生缩短学习曲线,推动机器人胰腺手术在基层单位开展普及,促进我国机器人胰腺外科的发展,让越来越多的患者能够从微创技术的发展中获益。

Robotic surgery has demonstrated obvious advantages in precise and complex operations, and its application in urology, gastrointestinal surgery and obstetrics and gynecology has gradually become widespread. However, its development in pancreatic surgery has been relatively slow. From 2011 to 2025, the author′s team completed a total of 5, 500 robotic pancreatic surgeries. Based on the summary of the above-mentioned surgical experiences, the author proposed new technologies, new concepts, and new sub-specialties. Among them, the new technologies include standardized port placement, the application of L-hole and R-hole, 301 pancreaticojejunostomy, robotic radical antegrade modular pancreatosplenectomy using the flip-up approach, and Rong′s surgery. The new concepts include: circumferential vessel resection techniques and low-tension and low-stress anastomosis; New Sub-specialty: Pancreatic Duct (Repair) Surgery. These experiences and concepts can help robotic pancreatic surgeons shorten their learning curve, promote the adoption of robotic pancreatic surgery in primary care settings, advance the development of robotic pancreatic surgery in China, and enable more patients to benefit from the progress of minimally invasive techniques.

1
Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital[J]. Arch Surg, 2003, 138(7):777-874.
2
Miller DW, Schlinkert RT, Schlinkert DK. Robot-assisted laparoscopic cholecystectomy: initial Mayo Clinic Scottsdale experience[J]. Mayo Clin Proc, 2004, 79(9):1132-1136.
3
Nio D, Bemelman WA, Busch OR, et al. Robot-assisted laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a comparative study[J]. Surg Endosc, 2004, 18(3):379-382.
4
Roder JD, Stein HJ, B?ttcher KA, et al. Stented versus nonstented pancreaticojejunostomy after pancreatoduodenectomy: a prospective study[J]. Ann Surg, 1999, 229(1):41-48.
5
Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies[J]. Ann Surg, 2006, 244(1):10-5.
6
Napoli N, Kauffmann EF, Menonna F, et al. Robotic versus open pancreatoduodenectomy: a propensity score-matched analysis based on factors predictive of postoperative pancreatic fistula[J]. Surg Endosc, 2018, 32(3):1234-1247.
7
Zureikat AH, Beane JD, Zenati MS, et al. 500 minimally invasive robotic pancreatoduodenectomies: one decade of optimizing performance[J]. Ann Surg, 2021, 273(5):966-972.
8
Shi Y, Jin J, Qiu W, et al. Short-term outcomes after robot-assisted vs open pancreaticoduodenectomy after the learning curve[J]. JAMA Surg, 2020, 155(5):389-394.
9
Jones LR, Zwart MJW, de Graaf N, et al. Learning curve stratified outcomes after robotic pancreatoduodenectomy: international multicenter experience[J]. Surgery, 2024, 176(6):1721-1729.
10
Rice MK, Hodges JC, Bellon J, et al. Association of mentorship and a formal robotic proficiency skills curriculum with subsequent generations' learning curve and safety for robotic pancreaticoduodenectomy[J]. JAMA Surg, 2020, 155(7):607-615.
11
Liu Q, Zhao G, Zhao Z, et al. The standardized technique in robotic radical antegrade modular pancreatosplenectomy using the flip-up approach[J]. Langenbecks Arch Surg, 2021, 406(5):1697-1703.
12
Zhao G, Liu Q, Zhao Z, et al. The standardized technique and surgical video of robotic pancreaticoduodenectomy at the Chinese PLA General Hospital[J]. Updates Surg, 2022, 74(1):245-254.
13
Liu R, Liu Q, Zhao G, et al. Single-port (SP) robotic pancreatic surgery using the da Vinci SP system: a retrospective study on prospectively collected data in a consecutive patient cohort[J]. Int J Surg, 2022, 104:106782.
14
Liu R, Liu Q, Zhao ZM, et al. Robotic versus laparoscopic distal pancreatectomy: A propensity score-matched study[J]. J Surg Oncol, 2017, 116(4):461-469.
15
Liu Q, Zhao Z, Gao Y, et al. Novel single-layer continuous suture of pancreaticojejunostomy for robotic pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci, 2020, 27(2):56-63.
16
Liu Q, Zhao Z, Zhang X, et al. Robotic pancreaticoduodenectomy in elderly and younger patients: A retrospective cohort study[J]. Int J Surg, 2020, 81:61-65.
17
Liu Q, Zhao Z, Gao Y, et al. Novel technique for single-layer pancreatojejunostomy is not inferior to modified blumgart anastomosis in robotic pancreatoduodenectomy: results of a randomized controlled trial[J]. Ann Surg Oncol, 2021, 28(4):2346-2355.
18
Liu Q, Zhao Z, Zhang X, et al. Perioperative and oncological outcomes of robotic versus open pancreaticoduodenectomy in low-risk surgical candidates: a multicenter propensity score-matched study[J]. Ann Surg, 2023, 277(4):e864-e871.
19
Liu Q, Li M, Gao Y, et al. Effect of robotic versus open pancreaticoduodenectomy on postoperative length of hospital stay and complications for pancreatic head or periampullary tumours: a multicentre, open-label randomised controlled trial[J]. Lancet Gastroenterol Hepatol, 2024, 9(5):428-437.
20
Liu R, Wakabayashi G, Palanivelu C, et al. International consensus statement on robotic pancreatic surgery[J]. Hepatobiliary Surg Nutr, 2019, 8(4):345-360.
21
Liu R, Abu Hilal M, Besselink MG, et al. International consensus guidelines on robotic pancreatic surgery in 2023[J]. Hepatobiliary Surg Nutr, 2024, 13(1):89-104.
22
刘荣,王子政,高元兴,等. 机器人"荣氏"胰腺中段切除术一例报道[J/OL]. 中华腔镜外科杂志(电子版), 2017, 10(5): 319-320.
23
Wang ZZ, Zhao GD, Zhao ZM, et al. An end-to-end pancreatic anastomosis in robotic central pancreatectomy[J]. World J Surg Oncol, 2019, 17(1):67.
24
Wang ZZ, Zhao GD, Zhao ZM, et al. A comparative study of end-to-end pancreatic anastomosis versus pancreaticojejunostomy after robotic central pancreatectomy[J]. Updates Surg, 2021, 73(3):967-975.
25
刘荣,刘渠,赵国栋,等. 环血管技术在胰十二指肠切除术中的应用[J]. 解放军医学院学报2022, 43(11): 1109-1112.
26
刘荣,刘渠. 外科低张力低应力重建[J/OL]. 中华腔镜外科杂志(电子版), 2023, 16(1):1-4.
27
Wang CY, Huang TS, Zhang KD, et al. Retrocolic versus antecolic gastrointestinal reconstruction in robotic pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci, 2019, 26(11):517-523.
28
Deng Z, Zhao G, Wang Z, et al. Robotic Taj Mahal hepatectomy for hilar cholangiocarcinoma[J]. J Vis Exp, 2022, (185).
29
刘俊峰,白世祥. 消化道吻合口的愈合过程[J]. 医学理论与实践1991, (6): 4-6.
30
刘志平,王志伟,朱铭岩,等. 胰空肠端侧吻合术生物力学及病理学研究[J]. 肝胆外科杂志2010, 18(2): 135-138.
31
孙备,李轶龙. 胰十二指肠切除术消化道重建方式合理选择与评价[J]. 中国实用外科杂志2012, 32(8): 629-631.
32
刘荣,刘渠,王子政,等. 胰管(修复)外科的理论及实践[J]. 科学通报2023, 68(18): 2376-2387.
33
Kleespies A, Rentsch M, Seeliger H, et al. Blumgart anastomosis for pancreaticojejunostomy minimizes severe complications after pancreatic head resection[J]. Br J Surg, 2009, 96(7):741-750.
34
Zhang XP, Xu S, Zhao ZM, et al. Outcomes of robotic versus laparoscopic pancreatoduodenectomy following learning curves of surgeons: a multicenter study on 2255 patients[J]. Ann Surg, 2023, 11.
35
刘荣. 胰腺良性肿瘤外科治疗的新方法——胰管外科[J]. 中国医刊2022, 57(11): 1177-1179.
36
中国研究型医院学会微创外科专业委员会. 胰管(修复)外科专家共识[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18(2): 65-72.
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