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中华胸部外科电子杂志 ›› 2025, Vol. 12 ›› Issue (01) : 1 -11. doi: 10.3877/cma.j.issn.2095-8773.2025.01.01

指南与共识

穿刺手术机器人辅助经皮肺穿刺诊疗技术:临床规范化应用专家共识
崔飞1, 陈延伟2, 薛兴阳1, 刘君1, 邵文龙1, 龙发3, 黎雨4, 顾春东5, 张健6, 张弘浩1, 李鑫1, 李时悦2,(), 何建行1,()   
  1. 1. 510120 广州,广州医科大学附属第一医院胸外科
    2. 510163 广州,广州医科大学附属第一医院呼吸内科
    3. 518106 深圳,深圳市光明区人民医院呼吸与危重症医学科
    4. 530007 南宁,广西医科大学第二附属医院呼吸与危重症医学科
    5. 116011 大连,大连医科大学附属第一医院胸外科
    6. 528403 中山,中山市人民医院介入医学科
  • 收稿日期:2024-12-19 修回日期:2025-01-15 接受日期:2025-02-07 出版日期:2025-02-28
  • 通信作者: 李时悦, 何建行
  • 基金资助:
    国家重点研发计划(2022YFB4702600)广州市临床重大技术项目(2023C-ZD01)广州市科技计划市校(院)联合资助项目(202201020465)

Expert consensus on the operating specifications of robot-assisted percutaneous surgery system in percutaneous lung puncture for diagnosis and treatment

Fei Cui1, Yanwei Chen2, Xingyang Xue1, Jun Liu1, Wenlong Shao1, Fa Long3, Yu Li4, Chundong Gu5, Jian Zhang6, Honghao Zhang7, Xin Li1, Shiyue Li2,(), Jianxing He1,()   

  1. 1. Department of Thoracic Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China
    2. Respiratory Medicine Department,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510163,China
    3. Department of Pulmonary and Critical Care Medicine,Shenzhen Guangming District People's Hospital,Shenzhen 518106,China
    4. Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Guangxi Medical Uniνersity,Nanning 530007,China
    5. Department of Thoracic Surgery,the First Affiliated Hospital of Dalian Medical Uniνersity,Dalian 116011,China
    6. Department of Interventional Medicine,Zhongshan City People's Hospital,Zhongshan 528403,China
    7. Department of Thoracic Surgery,the First Affiliated Hospital of Guangzhou Medical Uniνersity,Guangzhou 510120,China
  • Received:2024-12-19 Revised:2025-01-15 Accepted:2025-02-07 Published:2025-02-28
  • Corresponding author: Shiyue Li, Jianxing He
引用本文:

崔飞, 陈延伟, 薛兴阳, 刘君, 邵文龙, 龙发, 黎雨, 顾春东, 张健, 张弘浩, 李鑫, 李时悦, 何建行. 穿刺手术机器人辅助经皮肺穿刺诊疗技术:临床规范化应用专家共识[J/OL]. 中华胸部外科电子杂志, 2025, 12(01): 1-11.

Fei Cui, Yanwei Chen, Xingyang Xue, Jun Liu, Wenlong Shao, Fa Long, Yu Li, Chundong Gu, Jian Zhang, Honghao Zhang, Xin Li, Shiyue Li, Jianxing He. Expert consensus on the operating specifications of robot-assisted percutaneous surgery system in percutaneous lung puncture for diagnosis and treatment[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2025, 12(01): 1-11.

肺癌是我国乃至全球发病率和死亡率最高的癌症,针对该疾病的精准诊断和治疗对提高患者的生存率和生活质量至关重要。计算机断层扫描(CT)引导下经皮肺穿刺术是肺部疾病诊断与治疗的重要手段,但传统方法主要依赖于医生的专业技术水平和手术经验。穿刺手术机器人整合了系列新兴技术,通过穿刺路径规划、呼吸运动监控、机器人辅助定位等,提高了经皮肺穿刺的准确性和安全性,降低了操作难度,减少了并发症的发生。该技术已在肺组织活检、肺癌消融治疗、胸腔镜手术术前定位等临床场景中被越来越多地应用和推广。为规范穿刺手术机器人辅助CT引导下经皮肺穿刺诊断、治疗和定位的操作流程和技术要点,由广东省胸部疾病学会组织胸外科、呼吸科、肿瘤科、介入科等领域的专家共同制订本专家共识。

Lung cancer is a malignant tumor with the highest morbidity and mortality both in China and even in the world.Accurate diagnosis and treatment of this disease are crucial to improving the survival and quality of life of patients.Computed tomography (CT)-guided percutaneous lung puncture is an important method for the diagnosis and treatment of lung diseases,but heavily relies on doctors' professional skills and surgical experience in practices.The robot-assisted percutaneous surgery system integrates a series of emerging technologies to improve the accuracy and safety of percutaneous lung puncture,reduce the difficulty of operation,and reduce the occurrence of complications through puncture path planning,respiratory movement monitoring,robot-assisted positioning,etc.This technology has been increasingly used in clinical scenarios,such as lung biopsy,ablation,and preoperative localization for thoracoscopic surgery.In order to standardize the operating procedures of CT-guided percutaneous lung puncture for diagnosis,treatment and localization with the robot-assisted percutaneous surgery system and to summarize key points,Guangdong Association of Thoracic Diseases organized experts from various fields (thoracic surgery,respiratory medicine,oncology,interventional therapy,etc.) to develop this expert consensus.

图1 穿刺手术机器人辅助肺组织单病灶活检临床案例。女性患者,47岁,病灶位于右肺下叶肺底(2.6 cm×2.1 cm):穿刺手术机器人手术规划系统界面显示跨层面规划路径(红色所示)横断位(A)和失状位(B);完成穿刺定位后CT扫描验证横断位(C)和失状位(D)
图2 穿刺手术机器人辅助肺多发结节活检临床案例。男性患者,54岁,双肺肺结节活检,病灶1位于右肺下叶(1.0 cm×0.9 cm),病灶2位于左肺下叶(0.8 cm×0.8 cm):病灶1(A)和病灶2(C)穿刺手术机器人手术规划系统界面显示规划路径(红色所示);病灶1(B)和病灶2(D)完成穿刺定位后CT扫描验证
图3 穿刺手术机器人辅助肺癌射频消融临床案例。女性患者,62岁,病灶位于右肺中叶(0.5 cm×0.3 cm):穿刺手术机器人手术规划系统界面显示头侧向足侧跨层面规划路径(紫色所示)横断位(A)和失状位(B);完成穿刺定位后CT扫描验证(C)
图4 穿刺手术机器人辅助肺癌微波消融临床案例。女性患者,69岁,病灶位于右肺中叶肺门区(0.6 cm×0.5 cm):术前CT扫描(A);穿刺手术机器人手术规划系统界面显示规划路径(B;紫色所示);完成穿刺定位后CT扫描验证(C)
图5 穿刺手术机器人辅助肺癌冷冻消融临床案例。男性患者,57岁,病灶位于左肺下叶,左心室下方主动脉旁(3.0 cm×3.0 cm):穿刺手术机器人手术规划系统界面显示规划路径(A;紫色所示);完成穿刺定位后CT扫描验证(B);冷冻消融后CT扫描(C)
图6 穿刺手术机器人辅助肺癌激光消融临床案例。女性患者,66岁,多病灶消融,病灶1位于右肺下叶(0.7 cm×0.5 cm),病灶2位于右肺上叶(0.7 cm×0.5 cm),病灶3位于右肺上叶(0.9 cm×0.7 cm):病灶1(A)、病灶2(D)和病灶3(G)穿刺手术机器人手术规划系统界面显示规划路径(红色所示);病灶1(B)、病灶2(E)和病灶3(H)完成穿刺定位后CT扫描验证;病灶1(C)、病灶2(F)和病灶3(I)激光消融后CT扫描
图7 穿刺手术机器人辅助肺结节胸腔镜手术术前定位临床案例。女性患者,52岁,病灶位于左肺下叶(0.7 cm×0.5 cm):穿刺手术机器人手术规划系统界面显示规划路径(A;红色所示);完成穿刺定位后CT扫描验证(B);完成定位后CT扫描(C)
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