機械手臂輔助手術在台灣施行的現況

Current Status of Robotic Surgery in Taiwan

達文西機械手臂輔助手術是近年來新興的外科領域。基本上，機械手臂手術與腹腔鏡手術的方法完全一樣，只是，傳統腹腔鏡是用徒手操作，而機械手臂手術是外科醫師坐在駕駛艙中觀看3D的影像，將訊號傳輸到機械手臂來進行手術。達文西手術大家一致的共識是視野清晰、切割過程穩定、精準，尤其是一些較難接近的局限性解剖構造如攝護腺和低位直腸癌，有它的優越性能。但是達文西手術有它的缺點，就是手術過程外科醫師完全缺乏觸感、費用太貴、機械手臂會互相碰撞等等問題。但是，隨著器械的改良，相信它將來會是一個重要的外科領域。目前國内外有許多廠商競相開發機械手臂的相關醫材，將來手術的費用，也有下降的空間。新一代的外科醫師，必須密切注意此領域的發展，以免被時代的潮流淘汰。

daVinci® robotic surgery is a new emerging surgical field. Basically, robotic surgery is the same as pure laparoscopic surgery in the context of surgical dissection. However, pure laparoscopic surgery is performed through manual operation but the robotic surgery is performed with robotic arms, which receive the operative signal from surgical console. It is generally accepted that robotic surgery is very stable and precise for the surgery of fixed organs located in the limited space, such as prostate and distal rectal cancer. Remarkably, the inherent disadvantages of daVinci® system include: totally lack of haptic sensation, very high cost, and the external and internal collisions between robotic arms. However, with further refinement of robotics, I think we have to look toward the new technology that will carry us to a difference.