中国实用外科杂志2026，Vol.46Issue(6)：761-764,4.DOI:10.19538/j.cjps.issn1005-2208.2026.06.08
机器人甲状腺手术空间构建策略及操作技巧
Strategies and operative techniques for surgical space creation in robotic thyroid surgery
摘要
Abstract
Robotic thyroid surgery relies on remote concealed incisions,and the extension of operative channels combined with the absence of a natural surgical field makes space creation a key technical challenge.Surgical space creation should focus on counteracting the"tenting effect"caused by tissue elastic recoil and follow three key principles:precise anatomical layering,formation of a stable visual triangle between the camera and instruments,and kinematic matching of trocar positions.Dissection of the cervical skin flap requires accurate identification of the loose connective tissue between the superficial cervical fascia and the superficial layer of the deep cervical fascia,thereby avoiding vascular injury,intraoperative oozing,and restriction of the effective working space caused by an excessively superficial or deep plane.The camera and bilateral robotic arms should remain centered,symmetrical,and at a consistent depth to maintain a stable and efficient operative view.Trocar port design should increase the distance between internal ports and maintain consistent instrument orientation to reduce collisions between robotic arms and intracorporeal instruments.Low-pressure insufflation management emphasizes maintaining a stable pressure of 6-8 mmHg,together with a dedicated smoke evacuation channel and a dry operative field,to ensure continuous operation.Team collaboration improves efficiency through closed-loop actions for space maintenance,field cleaning,and collision management.In a broader sense,space creation also extends to fascial dissection of the thyroid gland and lymphatic tissues,requiring robotic instruments to maintain tissue tension,accurately identify fascial planes,and protect key structures such as the recurrent laryngeal nerve.Stable control of CO2 pressure and pre-deployment of robotic arms outside the body can reduce intraoperative collisions and visual interference.The introduction of artificial intelligence(AI)is promoting the transformation of surgical experience into digital decision support,and clinical teams need standardized training and adaptive paradigms to advance high-quality development of this procedure.关键词
机器人甲状腺手术/空间构建/膜解剖/规范化操作/并发症防控Key words
robotic thyroid surgery/space creation/fascial dissection/standardized operation/complication prevention and control分类
医药卫生引用本文复制引用
严佶祺,孙寒星,王越..机器人甲状腺手术空间构建策略及操作技巧[J].中国实用外科杂志,2026,46(6):761-764,4.基金项目
Shanghai Characteristic Disease Cohort Database Construction Project(No.SHDC2020R6003) 上海市特色专病队列数据库建设项目(No.SHDC2020R6003) （No.SHDC2020R6003）
