機器手臂手術在耳鼻喉頭頸外科的應用

機器手臂手術提供了立體且放大的手術視野，可完成多角度的精細手部關節活動，有助於在狹小手術傷口中的操作，在近年已廣泛應用於不同種類的外科手術。在耳鼻喉頭頸外科方面，自最早使用在舌根腫瘤切除成功後，根據這個概念隨之發展出來的經口機器手臂手術也隨後取得核准。機器手臂手術的各種手術方法在世界各地陸續發展，機器手臂手術儼然成為耳鼻喉頭頸之新興領域。除了經口機器手臂手術外，甲狀腺機器手臂手術已在亞洲有相當卓越的發展，針對甲狀腺腫瘤或癌症患者，提供了改善術後外觀條件及生理功能的新選項。隨後發展的頸部淋巴廓清術及其他頸部腫瘤手術的應用，也大幅改善病人的生活品質。因為屬於新發展的領域，目前機器手臂手術仍有一些應用上的限制，如價格高昂、手術器械未完全適合頭頸外科、腫瘤治療效果仍待確認、手術技巧困難等問題，但隨著標準化訓練課程的建立、新器械的發展、及治療經驗的累積，這些問題將在不久的未來被逐步克服，讓機器手臂手術成為耳鼻喉頭頸外科醫師的另一項治療利器。

關鍵字

robotic surgery ； head and neck surgery ； minimally invasive surgery ； scarless surgery（機器手臂手術；頭頸外科；微創手術；無疤痕手術）

並列摘要

Robotic surgery provides three-dimensional and magnified views, dexterous movement of the surgical instruments, and tremor-free and remote control. It is therefore appropriate to be applied in the small and remote surgical fields where the instruments used in the traditional surgery difficult to approach. When the first approved indication of treating oropharyngeal tumors by transoral robotic surgery (TORS), new applications and novel surgical techniques and devices had been developed to facilitate the utility of robotic surgery in otolaryngology and head neck. For head and neck, robotic surgery provides a new option to maintain esthetic and physiological function, which significantly reduces post-operative morbidities and promotes life qualities. Although the limitations of robotic surgery still exist based on the current design of the surgical robotic system including cost, bulky instruments, insufficient evidences of oncological outcome, and the long learning curve for operators, it is believed to be overcome in the near future with well-established training curriculum, development of new instruments, and accumulation of surgical experience. Robotic surgery will potentiate and extend the therapeutic possibility in otolaryngology and head neck.

並列關鍵字

robotic surgery ； head and neck surgery ； minimally invasive surgery ； scarless surgery

國際替代計量

機器手臂手術在耳鼻喉頭頸外科的應用

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