呼吸器外科におけるロボット手術の現況と上手に行うための工夫

抄録

　The most favorable advantage of robotic surgery is the markedly free movement of joint-equipped robotic forceps under 3-dimensional high-vision. Accurate operation makes complex procedures straightforward and may overcome weak points of previous thoracoscopic surgery. The efficiency and safety improves with acquiring skills. However, the spread of robotic surgery in the general thoracic surgery field has been delayed compared to those in other fields. The surgical indications include primary lung cancer, thymic diseases, and mediastinal tumors, but it is unclear whether technical advantages felt by operators are directly connected to merits for patients. Moreover, problems concerning the cost and education have not been solved. Although evidence is insufficient for robotic thoracic surgery, it may be an extension of thoracoscopic surgery, and reports showing its usefulness for primary lung cancer, myasthenia gravis, and thymoma have been accumulating. However, the spread in the robot-assisted thoracic surgery does not progress as expected at present. Because target area is wide in the thoracic cavity, it is necessary for safe and effective utilization of da Vinci by devising it. There are many problems including education, training, cost, advanced medical care, the insurance publication for the future development.