国产机器人系统在口腔颌面外科手术中的初步应用  

Preliminary application of domestic robotic system in oral and maxillofacial surgery

作　　者：孙晴 向熙婷 马超[1] 吴立萌 孙羲昆 张韬[1] SUN Qing;XIANG Xi-ting;MA Chao;WU Li-meng;SUN Xi-kun;ZHANG Tao(Department of Stomatology,Peking Union Medical College Hospital&Chinese Academy of Medical Science.Beijing 100730,China;Department of Plastic and Reconstructive Surgery,Peking Union Medical College Hospital&Chinese Academy of Medical Science.Beijing 100730,China;Department of Operating Room,Peking Union Medical College Hospital&Chinese Academy of Medical Science.Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院口腔科,北京100730 [2]中国医学科学院北京协和医院整形外科,北京100730 [3]中国医学科学院北京协和医院手术室,北京100730

出　　处：《中国口腔颌面外科杂志》2025年第1期13-19,共7页China Journal of Oral and Maxillofacial Surgery

基　　金：中央高水平临床科研专项基金(2022-PUMCH-B-036);北京市自然科学基金面上项目(4222040)。

摘　　要：目的:探讨国产机器人系统在口腔颌面外科手术中的应用效果,为机器人辅助技术在口咽及面颈部肿瘤切除重建手术中的应用提供参考。方法:纳入2023年11月—2024年6月北京协和医院口腔颌面外科应用国产康多机器人系统辅助口腔颌面外科手术的患者18例。其中,涉及口咽肿瘤13例、面颈部肿瘤3例、背阔肌皮瓣制取2例。统计手术时间、机器人操作时间、住院时间、术后并发症以及患者的面部美观度、面部口周水肿、颞下颌关节不适等指标。结果:所有手术均在机器人辅助下顺利进行,未中途转为传统开放手术。机器人操作时间平均(123.1±85.8)min,总手术时间平均(333.7±250.2)min,术后住院时长(5.89±4.56)天。口咽肿瘤中行肿瘤扩大切除术9例、活检术4例,其中4例同期行局部瓣移植修复术,2例同期进行前臂游离皮瓣移植修复术。口咽肿瘤患者术后均恢复良好,无迟发性出血发生。所有皮瓣均成活,术后病理无切缘阳性。所有患者拔管后均可经口正常进食、无明显呛咳,如期拔除气管切开套管。1例患者术中出现颞下颌关节脱位,予以手法复位。1例下颌下腺手术患者术后第2天出现术区血肿,经血肿清除后痊愈,其余患者均无并发症发生。术后3天随访患者有不同程度的面部口周水肿、局部麻木等,术后3个月随访所有患者均无不适,所有患者随访期内外观满意度评分为非常满意。结论:国产康多机器人系统在口腔颌面外科手术中的初步应用显示出良好效果,尤其在减少手术创伤、提高患者生活质量方面具有潜在优势。未来的发展应集中于改进设备的精细度和适用性,研发口腔颌面外科专用设备,以便更好地应用于复杂的口腔颌面外科手术。PURPOSE:To explore the application effect of domestic robot system in oral and maxillofacial surgery,and to provide reference for the application of robot-assisted technology in the resection and reconstruction of oropharyngeal and facial-neck tumors.METHODS:Eighteen patients underwent surgeries assisted by KangDuo Surgical System at the Department of Oral and Maxillofacial Surgery,Peking Union Medical College Hospital,between November 2023 and June 2024.These cases comprised 13 oropharyngeal tumors,three facial neck tumors,and a pair of latissimus dorsi myocutaneous flap procedures.Operation duration,robot operating time,hospitalization periods,postoperative complications,facial aesthetics,facial perioral edema,temporomandibular joint discomfort,and other parameters were analyzed statistically.RESULTS:All operations were successfully completed using the robotic system without requiring conversion to traditional open surgery.The mean operation time using the robotic assistance reached(123.1±85.8)min with a mean total operation time of(333.7±250.2)min.The average postoperative stay in the hospital was recorded as(5.89±4.56)days.In the management of oropharyngeal tumors,9 patients underwent tumor resections while 4 patients received biopsies.Four cases simultaneously underwent local flap transplantation,and 2 cases received forearm free flap transplants concurrently.All patients with oropharyngeal tumors demonstrated satisfactory recovery following surgical procedures,with no delayed bleeding reported.A 100%survival rate was noted for all flaps utilized,and postoperative pathological examinations revealed no positive surgical margins.After extubation,all patients could eat normally without experiencing significant coughing episodes,tracheotomy tubes were removed according to schedule.A dislocation of the temporomandibular joint was observed in one patient during the procedure,which subsequently improved following manual reduction.Additionally,one patient developed a hematoma at this site on the second postoperat

关 键 词：机器人辅助手术 口腔颌面外科手术 国产机器人 口咽肿瘤 颌面部肿瘤 修复重建 

分 类 号：R739.8[医药卫生—肿瘤]