单孔机器人结直肠癌手术的研究进展

doi:10.16139/j.1007-9610.2026.02.01

摘要/Abstract

摘要：

本文系统综述单孔机器人结直肠癌手术的研究进展。在介绍以达·芬奇SP及国产术锐^®、精锋^®、图迈^®等为代表的主流单孔机器人平台技术特点的基础上，综合现有临床研究数据，探讨单孔机器人在结直肠癌手术中的可行性、安全性及有效性。同时，梳理单孔机器人结直肠癌手术的学习曲线特征、技术局限性、临床适应证以及未来发展，以期为临床医师开展相关手术提供循证依据与实践参考。

关键词: 结直肠癌, 机器人, 单孔手术

Abstract:

This paper systematically reviewed the research progress in single-port robotic colorectal cancer surgery. After introducing the technical features of mainstream single-port robotic platforms, represented by the da Vinci SP and domestic platforms such as Surgerii^®, Edge^®, and Toumai^®, it synthesized existing clinical research data to explore the feasibility, safety, and efficacy of single-port robots in colorectal cancer surgery. Meanwhile, it outlined the learning curve characteristics, technical limitations, clinical indications, and future developments of single-port robotic colorectal cancer surgery, aiming to provide evidence-based guidance and practical references for clinicians performing such procedures.

Key words: Colorectal cancer, Robot, Single-port surgery

中图分类号:

宋子甲, 赵任. 单孔机器人结直肠癌手术的研究进展[J]. 外科理论与实践, 2026, 31(02): 95-99.

SONG Zijia, ZHAO Ren. Research progress of single-port robotic colorectal cancer surgery[J]. Journal of Surgery Concepts & Practice, 2026, 31(02): 95-99.

图/表 1

参考文献 24

[1]	BRAY F, LAVERSANNE M, SUNG H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3):229-263.
[2]	JACOBS M, VERDEJA J C, GOLDSTEIN H S. Minimally invasive colon resection (laparoscopic colectomy)[J]. Surg Laparosc Endosc, 1991, 1(3):144-150. pmid: 1688289
[3]	WILLIS F, AMATI A L, REICHERT M, et al. Current evidence in robotic colorectal surgery[J]. Cancers (Basel), 2025, 17(15):2503. doi: 10.3390/cancers17152503 URL
[4]	CHEN E, CHEN L, ZHANG W. Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration[J]. Front Oncol, 2025,15:1502014.
[5]	庄宝雄, 奚克兴, 邓海军. 单孔腹腔镜结直肠癌微创手术应用进展[J]. 消化肿瘤杂志(电子版), 2023, 15(2):120-125.
	ZHUANG B X, XI K X, DENG H J. Application progress of single-port laparoscopic minimally invasive surgery for colorectal cancer[J]. J Dig Oncol (Electronic Edition), 2023, 15(2):120-125.
[6]	宋子甲, 赵任. 单孔腹腔镜结直肠癌手术研究进展[J]. 中国实用外科杂志, 2019, 39(4):388-390.
	SONG Z J, ZHAO R. Research progress of single‑incision laparoscopic surgery for colorectal cancer[J]. Chin J Prac Surg, 2019, 39(4):388-390.
[7]	常浩生, 严力, 赵之明, 等. 达芬奇单孔机器人在外科手术中的应用及前景[J]. 腹腔镜外科杂志, 2022,(8):628-630.
	CHANG H S, YAN L, ZHAO Z M, et al. Application and prospect of da Vinci single‑port robot in surgical operations[J]. J Laparosc Surg, 2022,(8):628-630
[8]	COVAS MOSCHOVAS M, BHAT S, ROGERS T, et al. Applications of the da Vinci single port (SP) robotic platform in urology: a systematic literature review[J]. Minerva Urol Nephrol, 2021, 73(1):6-16. doi: 10.23736/S2724-6051.20.03899-0 pmid: 32993277
[9]	DITONNO F, PELLEGRINO A A, FRANCO A, et al. The single port robotic surgical "toolbox": a primer for beginners[J]. Minerva Urol Nephrol, 2024, 76(5):635-639. doi: 10.23736/S2724-6051.24.05766-5 pmid: 39320254
[10]	GUO Z, SHI Y, SONG Z, et al. Single-incision robotic assisted surgery: a nonrandomized cohort pilot study on a novel surgical platform in colorectal surgery[J]. Int J Surg, 2023, 109(11):3417-3429. doi: 10.1097/JS9.0000000000000612 URL
[11]	CUBISINO A, CHAZAL M, PANARO F. Application of the da Vinci single-port (SP) robot in general surgery: a first systematic review[J]. Int J Med Robot, 2025, 21(6):e70123. doi: 10.1002/rcs.v21.6 URL
[12]	KIM H S, OH B Y, CHUNG S S, et al. Short-term outcomes of single-incision robotic colectomy versus conventional multiport laparoscopic colectomy for colon cancer[J]. J Robot Surg, 2023, 17(5):2351-2359. doi: 10.1007/s11701-023-01666-z
[13]	JUNG J M, KIM Y I, YOON Y S, et al. Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts[J]. J Robot Surg, 2023, 17(6):2911-2917. doi: 10.1007/s11701-023-01727-3
[14]	ALSHALAWI W, LEE C S, KIM B C, et al. A comparative study on the short-term clinical outcomes of da Vinci SP versus da Vinci Xi for rectal cancer surgery[J]. Int J Med Robot,2023:e2558.
[15]	KIM H J, CHOI G S, PARK J S, et al. Comparison of the efficacy and safety of single-port versus multi-port robotic total mesorectal excision for rectal cancer: a propensity score-matched analysis[J]. Surgery, 2024, 175(2):297-303. doi: 10.1016/j.surg.2023.09.036 URL
[16]	KIM M H, YANG S, YOON Y S, et al. Short-term outcomes of da Vinci SP versus Xi for rectal cancer surgery: a propensity score matching analysis of two tertiary center cohorts[J]. Surg Endosc, 2025, 39(1):162-170. doi: 10.1007/s00464-024-11372-y
[17]	KELLER D S, REIF DE PAULA T, IKNER T P, et al. Perioperative outcomes for single-port robotic versus single-incision laparoscopic surgery: a comparative analysis in colorectal cancer surgery[J]. Surg Endosc, 2024, 38(3):1568-1575. doi: 10.1007/s00464-023-10629-2
[18]	MARKS J H, KUNKEL E, SALEM J F, et al. First clinical experience with single-port robotic transanal minimally invasive surgery: phase Ⅱ trial of the initial 26 cases[J]. Dis Colon Rectum, 2021, 64(8):1003-1013. doi: 10.1097/DCR.0000000000001999 URL
[19]	ALIPOURIANI A, OZGUR I, BHATT A, et al. Early experience with endorobotic submucosal dissection (ERSD): pathologic and short-term outcomes in the first 28 patients[J]. Ann Surg, 2025, 281(5):884-889. doi: 10.1097/SLA.0000000000006346 URL
[20]	HUANG C, SHI Y, SONG Z, et al. Single-port robotic-assisted colorectal surgery using the da Vinci SP system: a preliminary non-comparative exploratory cohort study[J]. Int J Surg, 2026, 112(2):3451-3456. doi: 10.1097/JS9.0000000000003915 URL
[21]	CHOI M S, YUN S H, LEE S C, et al. Learning curve for single-port robot-assisted colectomy[J]. Ann Coloproctol, 2024, 40(1):44-51. doi: 10.3393/ac.2022.00745.0106 URL
[22]	CHOI M S, YUN S H, OH C K, et al. Learning curve for single-port robot-assisted rectal cancer surgery[J]. Ann Surg Treat Res, 2022, 102(3):159-166. doi: 10.4174/astr.2022.102.3.159 pmid: 35317355
[23]	JEONG Y K, ALMALIK M A, KIM I K, et al. Learning curve for Da Vinci single-port robotic rectal cancer surgery[J]. J Robot Surg, 2025, 19(1):732. doi: 10.1007/s11701-025-02919-9
[24]	中国医师协会结直肠肿瘤专委会机器人外科学组, 许剑民, 何国栋, 等. 机器人结直肠癌手术中国专家共识(2025版)[J]. 中国普通外科杂志, 2025, 34(7):1307-1330.
	Robotic Surgery Group, Colorectal Cancer Committee of Chinese Medical Doctor Association, XU J M, HE G D, et al. Chinese expert consensus on robotic surgery for colorectal cancer(2025 edition)[J]. Chin J Gen Surg, 2025, 34(7):1307-1330.

作者(年份)	病种	例数	学习曲线评估方法	学习曲线拐点	学习阶段划分	主要结论
Choi等^[21](2024)	结肠癌	39	CUSUM法评估总手术时间、装机时间以及医师操作机器人时间	第18例	3阶段（第1~11例，第12~22例，第23~39例）	各阶段医师操作机器人时间具有显著差异（P<0.001），后期手术效率明显提升
Choi等^[22](2022)	直肠癌	57	CUSUM法评估总手术时间、装机时间以及医师操作机器人时间	第21例	3阶段（第1~16例，第17~32例，第33~57例）	中后期阶段手术时间显著缩短，手术并发症发生率未见明显升高
Jeong等^[23](2025)	直肠癌	73	CUSUM法评估手术时间以及手术失败（定义为中转手术、发生术后并发症或淋巴结获取不足12枚）	第46例	2阶段（第1~46例，第47~73例）	第2阶段平均手术时间显著缩短，并发症仅发生于第1阶段