Cirugía Colorrectal asistida por robot

Cirugía Colorrectal asistida por robot

Robot-Assisted Colorectal Surgery

D. Alías Jiménez*, M. Labalde Martínez*, Ó. García Villar*, E. Rubio González*, A. Vivas López*, C. Nevado García*, P. Peláez Torres*, F.J. García Borda*, E. Ferrero Herrero*

* Servicio de Cirugía General, Aparato Digestivo y Trasplante de
     Órganos Abdominales. Unidad de Cirugía Colorrectal. Hospital
     Universitario 12 de Octubre. Madrid (España).

DOI: https://doi.org/10.14679/3503

Resumen:

La llegada de la cirugía robótica ha supuesto un importante salto de calidad para poder llevar a cabo un abordaje mínimamente invasivo en nuestros pacientes mediante procedimientos factibles y seguros. En 2023 se realizaron más de 25.000 intervenciones quirúrgicas en la península ibérica con estos dispositivos.
Su aplicación en el ámbito de la cirugía colorrectal ha facilitado la realización de anastomosis intracorpóreas, disección de pedículos vasculares y linfadenectomías en espacios anatómicos de difícil acceso como la pelvis, gracias al uso de instrumentos articulados y la visión en 3D.
Ya disponemos de evidencia en la literatura en la que se ponen de manifiesto los beneficios de la cirugía robótica colorrectal para el paciente con menor pérdida de sangre, estancia hospitalaria inferior, menor tasa de conversión, más rápida recuperación del tránsito intestinal e introducción de la dieta oral y sin inferioridad en los resultados oncológicos evaluados respecto a la cirugía abierta o laparoscópica.
Las curvas de aprendizaje para el manejo de estos dispositivos se ven favorecidas y acortadas por la disponibilidad de simuladores de fácil acceso y una consola dual que facilita la adquisición de destreza al realizar una formación compartida con un cirujano experto en cirugía robótica en la otra consola.
Por último, el coste económico continúa siendo el hándicap más importante para la compra de estos equipos, si bien en la evaluación de este siempre se deben considerar los beneficios que tiene su aplicación en el paciente y que a su vez tendrá repercusión en la institución.
Palabras clave: cirugía robótica colorrectal, revisión literatura, beneficios pacientes

Abstract:

The arrival of robotic surgery has represented an important leap in quality to be able to carry out a minimally invasive approach in our patients through feasible and safe procedures. In 2023, more than 25,000 surgical interventions were performed in the Iberian Peninsula with these devices.
Its application in the field of colorectal surgery has facilitated the performance of intracorporeal anastomoses, dissection of vascular pedicles and lymphadenectomies in difficult-to-access anatomical spaces such as the pelvis, thanks to the use of articulated instruments and 3D vision.
We already have evidence in the literature that shows the benefits of colorectal robotic surgery for the patient with less blood loss, shorter hospital stay, lower conversion rate, faster recovery of intestinal transit and introduction of the diet oral and without inferiority in the oncological results evaluated with respect to open or laparoscopic surgery.
The learning curves for the management of these devices are favored and shortened by the availability of easily accessible simulators and dual consoles that facilitate the acquisition of skill by performing shared training with a surgeon expert in robotic surgery on the other console.
Finally, the economic cost continues to be the most important handicap for the acquisition of this equipment, although in its evaluation you should always keep in mind the benefits that its application has on the patient and that in turn will have an impact on the institution.
Key words: colorectal robotic surgery, literature review, patients benefits

Bibliografía

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