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​David Rice、李鹤成教授共话达芬奇机器人手术

Published at: 2015年第1卷第S1期

高凤平
关键词:

编者按:10月14日至15日,由上海交通大学医学院附属瑞金医院胸外科主办,上海市抗癌协会,AME出版社协办的瑞金胸外论坛暨国家级继续教育项目《食管癌微创外科治疗》学习班在上海交通大学医学院附属瑞金医院盛大举行。大会围绕胸部肿瘤微创治疗新进展主题展开,国内外胸外专家针对目前国内外先进的技术理念(达芬奇机器人手术、单孔胸腔镜手术)和肺癌、食管癌最新治疗原则理念(如肺段切除、食管癌术前新辅助治疗)等话题进行了精彩分享讨论。此次,AME出版社有幸邀请到大会执行主席李鹤成教授与来自美国安德森癌症中心的David Rice教授共同就达芬奇机器人手术的话题进行了对话分享。

Fig 1:采访李鹤成教授与Prof. David Rice 

采访中,李教授与Prof. Rice分别与我们分享了当今达芬奇机器人手术在中国与美国的应用现状以及影响其应用的因素。无论是中国,还是美国,进行达芬奇机器人手术的成本仍旧是共同的限制。此外,Prof. Rice也说到了达芬奇机器手术的训练与其中的价值体现证明也是影响到其普及应用的因素。

谈及对年轻医生学习达芬奇机器人手术的建议,李教授与Prof. Rice都认为这是一个一步一脚印的过程,需要循序渐进地学习理论,了解机器人操作原理,以胸腔镜手术为基础,从简单的机器人手术开始不断地练习,以掌握成熟的技巧。

采访中,李教授提到了对机器人手术的初次兴趣源于2011年访学美国安德森癌症中心学习期间,从Prof. Rice身上所得的灵感,继而在后来开始了机器人手术的学习与实践。与李教授的第一次机器人手术的尝试相似,Prof. Rice也坦言他的第一次机器人手术并非容易,期间也经历过操作不适应的困境,但最后通过坚持地练习训练最终才有了如今的熟练,以此也鼓励正在尝试机器人手术的医生坚持练习,从简单手术做起。此外,李教授与Prof. Rice也与我们分享了达芬奇机器人手术的魅力所在。

而对于像达芬奇机器人这类新技术,李教授与Prof. Rice都认为在实际应用时最为重要的考虑因素仍是从病人利益出发,Prof. Rice同时也提到了其机构里所设立的一个专门小组,对新技术进行研究实践以造福病患。

谈及此前的AlphaGo话题以及对于机器人今后是否会取代外科医生角色的问题,李教授与Prof. Rice都一致给出了否定的答案,并各自说明了其看法。Prof. Rice认为今后机器人在外科中的发展方向应该是与3D图像技术的深化结合,以提供更为准确的手术界面。

同时,李教授与Prof. Rice也与我们分享了国内外胸外医生间手术技巧与学习研究等方面的差异不同。

采访尾声,问及对此次论坛的看法时,Prof. Rice开玩笑地说到了需要学习一下中文,随后也认真地对此次会议的手术演示与提供的交流平台表达了称赞之意(Prof. Rice虽不懂中文,但论坛期间仍是全程在场认真听看台上分享,并向讲者提出自己的疑问与看法)。

采访最后,李教授也简略与我们介绍了会议亮点及其主编的新书《瑞金胸外机器人手术学》。

想知道更多李教授与Prof. Rice的采访详情,还不猛戳以下视频:

 

采访问题:

  1. Today’s symposium is about Uniportal VATS and Da Vinci Robotic Surgery. Here I would like to ask what’s the current development of Da Vinci Robotic Surgery in your country? What do you think is the factor that might affect the application of this technique in your country?

  2. When you teach the young residents, what’ll be your advice for them for performing the Da Vinci Robotic Surgery? Or what mistake you think they could avoid? 

  3. Both of you are the experts in the Robotic Surgery, then do you still remember the first time when you do the Da Vinci Robotic Surgery? Would you like to share with us this experience? 

  4. What’s in Da Vinci Robotic Surgery that attracts you to do this? What’s its charming?

  5. Concerning the new technique, we know that both of you are focusing on practicing new and more innovative way of surgery for the benefit of patients. What’ll be your concern or what’ll you take into consideration when facing new technique or before applying them into our patients? 

  6. Previously, AlphaGo is quite a hot topic, shaking the world with its intelligence. For this kind of artificial intelligence, do you think in the future medical world, this intelligence or robot will replaces the role of surgeon?  

  7. One of you is a thoracic surgeon from China, and another from USA. What similarity and difference you find from each other? You may say the similarity and difference for Chinese and American thoracic surgeon. 

  8. Come back to the symposium today. Prof. Rice, what’s your idea on today’s symposium?

  9. Prof. Li, as the executive president of this symposium, would you like to tell us the highlight of this symposium? 

  10. Prof. Li, we also know that you have written a book about the Da Vinci Robotic Surgery Cases from Ruijin Hospital. Here would you like to take this chance to tell us some content of this book?

 

专家介绍:

David C. Rice, Professor in Department of Thoracic and Cardiovascular Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.

Since joining MD Anderson, Dr. Rice has striven to provide the best and most modern surgical care possible to patients with thoracic malignancies. His clinical interests have followed two very divergent paths. First, to continue to be a leader in the field of thoracic surgery by pushing the envelope and practicing new and more innovative ways of doing surgery that impart less surgical trauma and pain for the patient and yet offer the same oncologic benefit as traditional procedures. Dr. Rice and his colleagues have been active in greatly expanding the role of video assisted thoracoscopic (VATS) surgery in thoracic malignancies. Dr. Rice was the first surgeon to perform a minimally invasive esophagectomy at this institution. Similarly, Dr. Rice and his colleagues have greatly expanded the use of minimally invasive lobectomy and now offer this procedure routinely for patients with small-localized lung cancers. Dr. Rice participated as a founder in the development of the MINTOS (Minimally Invasive and New Technologies in Oncologic Surgery) working group and has fostered the use of endobronchial ultrasound (EBUS) guided mediastinal nodal biopsies in thoracic malignancies. 

李鹤成,上海交通大学附属瑞金医院胸外科主任。1996-目前从事胸部肿瘤(肺癌、食管癌、贲门癌、纵隔肿瘤等)的诊治工作,2004、2011年曾分别获国际抗癌联盟及复旦大学附属肿瘤医院资助到美国Vanderbilt大学肿瘤中心、Texas大学MD Anderson肿瘤中心及杜克大学医学中心学习肺癌食管癌的微创手术(胸腔镜手术和机器人外科手术)及胸膜间皮瘤的综合治疗。临床:熟悉肺癌、食管癌、贲门癌、纵隔肿瘤以手术为主的综合治疗;擅长肺癌、食管癌的微创手术,在国内较早开展全腔镜食管癌根治胸内吻合手术和胸腔镜肺段切除术。开创单操作孔胸腔镜食管癌根治胸内吻合术。科研:肺癌、食管癌的基础及临床转化型研究,主持国家自然科学基金2项、上海市科委资助项目2项,其他课题2项。国内外核心杂志发表论著40余篇,参与编写肿瘤学专著5本,第一作者或通讯作者SCI收录论文13篇。国家专利1项。获上海市科技启明星、上海市科技启明星跟踪计划、第十七届明治生命科学奖、中国抗癌协会科技进步三等奖。

 

采访编辑:高凤平

视频剪辑:麦雪芳

 

相关阅读:

doi: 

10.3978/kysj.2014.1.2211
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