手术机器人的出现使微创外科的发展迈上了一个崭新的台阶。目前，机器人技术在消化道手术领域的使用越来越普遍。 相较于传统腹腔镜手术和开放手术，机器人手术更擅长在狭窄空间内进行解剖操作，对组织的牵拉损伤更小，有利于患者术 后胃肠道功能的快速恢复，预后更好。但如何提高手术机器人及其配套设备的自主性是未来手术机器人的发展方向。另外， 可以预见的是，国产手术机器人与先进通信技术的结合将会使更多患者享受到远程手术医疗带来的益处。

The advent of surgical robot has taken minimally invasive surgery to a new level. Nowadays, the use of surgical robot is becoming more and more common in the field of digestive surgery. Compared with the conventional laparoscopic and open surgery, robot-assisted surgery is better at performing anatomical operations in a narrow space with less pulling damage to the tissues and better prognosis, which is beneficial to the rapid recovery of gastrointestinal function after surgery. How to improve the autonomy of surgical robot and its supporting equipment is the future direction. In addition, it is foreseeable that the combination of domestic surgical robots and latest communication technology will allow more patients to enjoy the benefits of telesurgery and telemedicine.

基金项目：中华医学会医学教育分会医学教育研究课题（20B0258）；吴阶平医学基金会临床科研专项资助基金（320.6750. 2023-23-8） 

Foundation Item: Medical Education Research Project of the Medical Education Branch of the Chinese Medical Association (20B0258);  Special Fund for Clinical Research of Wu Jieping Medical Association (320.6750.2023-23-8) 

引用格式：郑天祥，王东旺，张永年，等 . 机器人辅助手术在消化外科的应用现状及发展前景 [J]. 机器人外科学杂志（中英文），2025，6（4）： 601-606. 

Citation: ZHENG T X, WANG D W, ZHANG Y N, et al. Current status and prospects of robot-assisted gastrointestinal surgery [J]. Chinese  Journal of Robotic Surgery, 2025, 6(4): 601-606. 

通讯作者（Corresponding Author）：张新生（ZHANG Xinsheng），Email：zhangxs85@sina.com

[1] Melvin W S, Needleman B J, Krause K R, et al. Computer-enhanced robotic telesurgery. Initial experience in foregut surgery[J]. Surg Endosc, 2002, 16(12): 1790-1792. 

[2] Hosoda K, Niihara M, Harada H, et al. Robot-assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications[J]. Ann Gastroenterol Surg, 2020, 4(6): 608-617. 

[3] ZHANG Y J, DONG D, CAO Y Q, et al. Robotic versus conventional minimally invasive esophagectomy for esophageal cancer: a Metaanalysis[J]. Ann Surg, 2023, 278(1): 39-50. 

[4] YANG Y, LI B, YI J, et al. Robot-assisted versus conventional minimally invasive esophagectomy for resectable esophageal squamous cell carcinoma: early results of a multicenter randomized controlled trial: the RAMIE trial[J]. Ann Surg, 2022, 275(4): 646-653. 

[5] Kandagatla P, Ghandour A H, Amro A, et al. Long-term outcomes after robotic-assisted Ivor Lewis esophagectomy[J]. J Robot Surg, 2022, 16(1): 119-125. 

[6] Tolboom R C, Broeders I A, Draaisma W A. Robot-assisted laparoscopic hiatal hernia and antireflux surgery[J]. J Surg Oncol, 2015, 112(3): 266-270. 

[7] Benedix F, Adolf D, Peglow S, et al. Short-term outcome after robotassisted hiatal hernia and anti-reflux surgery-is there a benefit for the patient?[J]. Langenbecks Arch Surg, 2021, 406(5): 1387-1395. 

[8] MA L Y, LUO H, KOU S E, et al. Robotic versus laparoscopic surgery for hiatal hernia repair: a systematic literature review and meta-analysis[J]. J Robot Surg, 2023, 17(5): 1879-1890. 

[9] Soliman B G, Nguyen D T, Chan E Y, et al. Robot-assisted hiatal hernia repair demonstrates favorable short-term outcomes compared to laparoscopic hiatal hernia repair[J]. Surg Endosc, 2020, 34(6): 2495-2502. 

[10] Bigolin A V, Fonseca M K, Grossi J, et al. Robotic repair of postoesophagectomy hiatal hernia[J]. Ann R Coll Surg Engl, 2022, 104(6): e171-e173. 

[11] Arcerito M, Perez M G, Kaur H, et al. Robotic fundoplication for large paraesophageal hiatal hernias[J]. JSLS, 2020, 24(1): e2019.00054. 

[12] Ceccarelli G, Pasculli A, Bugiantella W, et al. Minimally invasive laparoscopic and robot-assisted emergency treatment of strangulated giant hiatal hernias: report of five cases and literature review[J]. World J Emerg Surg, 2020, 15(1): 37. 

[13] Hashizume M, Shimada M, Tomikawa M, et al. Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system[J]. Surg Endosc, 2002, 16(8): 1187-1191. 

[14] Guerrini G P, Esposito G, Magistri P, et al. Robotic versus laparoscopic gastrectomy for gastric cancer: The largest Meta-analysis[J]. Int J Surg, 2020. DOI: 10.1016/j.ijsu.2020.07.053. 

[15] Baral S, Arawker M H, Sun Q, et al. Robotic versus laparoscopic gastrectomy for gastric cancer: a mega Meta-analysis[J]. Front Surg, 2022. DOI: 10.3389/fsurg.2022.895976.

[16] Loureiro P, Barbosa J P, Vale J F, et al. Laparoscopic versus robotic gastric cancer surgery: short-term outcomes-systematic review and Meta-analysis of 25521 patients[J]. J Laparoendosc Adv Surg Tech A, 2023, 33(8): 782-800. 

[17] LI J T, LIN J X, WANG F H, et al. Comparison of long-term outcomes after robotic versus laparoscopic radical gastrectomy: a propensity scorematching study[J]. Surg Endosc, 2022, 36(11): 8047-8059. 

[18] Ojima T, Nakamura M, Hayata K, et al. Short-term outcomes of robotic gastrectomy vs laparoscopic gastrectomy for patients with gastric cancer: a randomized clinical trial[J]. JAMA Surg, 2021, 156(10): 954-963. 

[19] LU J, ZHENG C H, XU B B, et al. Assessment of robotic versus laparoscopic distal gastrectomy for gastric cancer: a randomized controlled trial[J]. Ann Surg, 2021, 273(5): 858-867. 

[20] CHEN Q Y, ZHONG Q, LIU Z Y, et al. Surgical outcomes, technical performance, and surgery burden of robotic total gastrectomy for locally advanced gastric cancer: a prospective study[J]. Ann Surg, 2022, 276(5): e434-e443. 

[21] LI Z Y, ZHOU Y B, LI T Y, et al. Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a multicenter cohort study of 5402 patients in China[J]. Ann Surg, 2023, 277(1): e87-e95. 

[22] LU J, LI T Y, ZHANG L, et al. Comparison of short-term and three-year oncological outcomes between robotic and laparoscopic gastrectomy for gastric cancer: a large multicenter cohort study[J]. Ann Surg, 2024, 279(5): 808-817. 

[23] ZHANG C, WEI M H, CAO L, et al. Performing robot-assisted pylorus and vagus nerve-preserving gastrectomy for early gastric cancer: a case series of initial experience[J]. World J Gastrointest Surg, 2022, 14(10): 1107-1119. 

[24] Papasavas P, Seip R L, Stone A, et al. Robot-assisted sleeve gastrectomy and Roux-en-y gastric bypass: results from the metabolic and bariatric surgery accreditation and quality improvement program data registry[J]. Surg Obes Relat Dis, 2019, 15(8): 1281-1290. 

[25] Napoli N, Kauffmann E F, Ginesini M, et al. Robotic pancreas-preserving total duodenectomy: first-world experience[J]. Updates Surg, 2023, 75(6): 1735-1740. 

[26] Alhossaini R M, Altamran A A, Cho M, et al. Lower rate of conversion using robotic-assisted surgery compared to laparoscopy in completion total gastrectomy for remnant gastric cancer[J]. Surg Endosc, 2020, 34(2): 847-852. 

[27] ZHANG Z, MIAO L, REN Z, et al. Robotic bariatric surgery for the obesity: a systematic review and Meta-analysis[J]. Surg Endosc, 2021, 35(6): 2440-2456. 

[28] Bertoni M V, Marengo M, Garofalo F, et al. Robotic-assisted versus laparoscopic revisional bariatric surgery: a systematic review and Metaanalysis on perioperative outcomes[J]. Obes Surg, 2021, 31(11): 5022-5033. 

[29] Weber P A, Merola S, Wasielewski A, et al. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease[J]. Dis Colon Rectum, 2002, 45(12): 1689-1696. 

[30] Cuk P, Kjær M D, Mogensen C B, et al. Short-term outcomes in robotassisted compared to laparoscopic colon cancer resections: a systematic review and Meta-analysis[J]. Surg Endosc, 2022, 36(1): 32-46. 

[31] HUANG Z L, HUANG S B, HUANG Y P, et al. Comparison of roboticassisted versus conventional laparoscopic surgery in colorectal cancer resection: a systemic review and Meta-analysis of randomized controlled trials[J]. Front Oncol, 2023, 13: 1273378. 

[32] FENG Q Y, YUAN W T, LI T Y, et al. Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial[J]. Lancet Gastroenterol Hepatol, 2022, 7(11): 991-1004. 

[33] Park J S, Lee S M, Choi G S, et al. Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial[J]. Ann Surg, 2023, 278(1): 31-38. 

[34] WU H M, GUO R K, LI H Y. Short-term and long-term efficacy in robotassisted treatment for mid and low rectal cancer: a systematic review and meta-analysis[J]. Int J Colorectal Dis, 2023, 39(1): 7. 

[35] Machairas N, Dorovinis P, Kykalos S, et al. Simultaneous roboticassisted resection of colorectal cancer and synchronous liver metastases: a systematic review[J]. J Robot Surg, 2021, 15(6): 841-848. 

[36] CHANG W J, YE Q H, XU D H, et al. Robotic versus open surgery for simultaneous resection of rectal cancer and liver metastases: a randomized controlled trial[J]. Int J Surg, 2023, 109(11): 3346-3353. 

[37] Fleming C A, Cullinane C, Lynch N, et al. Urogenital function following robotic and laparoscopic rectal cancer surgery: Meta-analysis[J]. Br J Surg, 2021, 108(2): 128-137. 

[38] Farah E, Abreu A A, Rail B, et al. Perioperative outcomes of robotic and laparoscopic surgery for colorectal cancer: a propensity score-matched analysis[J]. World J Surg Oncol, 2023, 21(1): 272. 

[39] Saeidi H, Opfermann J D, Kam M, et al. Autonomous robotic laparoscopic surgery for intestinal anastomosis[J]. Sci Robot, 2022, 7(62): eabj2908. 

[40] Eslamian S, Reisner L A, Pandya A K. Development and evaluation of an autonomous camera control algorithm on the da Vinci Surgical System[J]. Int J Med Robot, 2020, 16(2): e2036. 

[41] Özgüner O, Shkurti T, Huang S, et al. Camera-robot calibration for the Da Vinci® robotic surgery system[J]. IEEE Trans Autom Sci Eng, 2020, 17(4): 2154-2161. 

[42] Li N, Liu H, Abdolmalaki R Y, et al. s-CAM: an untethered insertable laparoscopic surgical camera robot with non-contact actuation[J]. Sensors (Basel), 2022, 22(9): 3405. 

[43] Runciman M, Darzi A, Mylonas G P. Soft robotics in minimally invasive surgery[J]. Soft Robot, 2019, 6(4): 423-443. 

[44] ZHANG B Y, FAN Y W, YANG P H, et al. Worm-like soft robot for complicated tubular environments[J]. Soft Robot, 2019, 6(3): 399-413. 

[45] Kim H, You J M, Kyung K U, et al. Endoscopic surgery robot that facilitates insertion of the curved colon and ensures positional stability against external forces: K-COLON[J]. Int J Med Robot, 2023, 19(3): e2493. 

[46] LIU Y X, WANG Y L M, WANG C L, et al. Comparison of short-term outcomes of robotic-assisted radical colon cancer surgery using the Kangduo surgical robotic system and the Da Vinci Si robotic system: a prospective cohort study[J]. Int J Surg, 2024, 110(3): 1511-1518. 

[47] ZHENG J L, WANG Y H, ZHANG J, et al. 5G ultra-remote robot-assisted laparoscopic surgery in China[J]. Surg Endosc, 2020, 34(11): 5172-5180. 

[48] LI J M, YANG X C, CHU G D, et al. Application of improved robotassisted laparoscopic telesurgery with 5G technology in urology[J]. Eur Urol, 2023, 83(1): 41-44.