警惕机器人辅助人工全膝关节置换术“学习曲线后”阶段的不良事件
Be alert to adverse events in the "post-learning curve" stage of robotic-assisted total knee arthroplasty
摘要机器人辅助人工全膝关节置换术(RATKA)可提高手术精准性,且学习曲线友好,已被越来越多的研究证实。然而,目前评价学习曲线的研究多以手术时长作为标准,但熟练并不意味着完全掌握RATKA手术技术。本文从RATKA的手术技术陷阱以及非手术技术层面的特有不良事件两个方面进行经验总结。提示手术医师在手术技术层面,只有充分理解机器人作为新工具与传统全膝关节置换术工作逻辑与原理的不同,才能避免“不满意病例”的出现;在非手术技术层面,只有充分了解各个环节中可能发生的并发症,才能有意识规避机器人的特有不良事件,最终使机器人真正成为外科医师的得力工具。
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abstractsMore and more studies have confirmed that robotic-assisted total knee arthroplasty (RATKA) can improve surgical accuracy and has a user-friendly learning curve. However, most current studies evaluating the learning curve use operative time as the standard of assessment, although proficiency does not equate to complete mastery of RATKA surgical techniques. This article will summarize experience from two perspectives: surgical technical pitfalls and non-surgical technical adverse events in RATKA. Regarding surgical techniques, it is essential to fully understand the differences in workflow and principles between RATKA and traditional total knee arthroplasty to avoid the occurrence of"unsatisfactory cases". At the non-surgical technical level, a comprehensive understanding of the various new complications that may arise during RATKA is necessary in order to consciously prevent adverse events. Ultimately, the robot will become a powerful tool for surgeons.
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