远程机器人手术的现状、风险特征与安全实施框架
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南京大学医学院附属金陵医院(东部战区总医院) 全军普通外科研究所,江苏 南京 210002

作者简介:

孙涵,南京大学医学院附属金陵医院硕士研究生,主要从事智能化技术在外科诊疗方面的研究。

基金项目:

江苏省医学创新中心基金资助项目(CXZX202217);江苏省南京市博士后基金资助项目(48143)。


Robotic telesurgery: current status, risk characteristics, and safety implementation framework
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Research Institute of General Surgery, Jinling Hospital (General Hospital of Eastern Theater Command), Medical School of Nanjing University, Nanjing 210002, China

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    摘要:

    随着通信技术与手术机器人技术的发展,远程机器人手术逐步由早期示范探索进入临床应用阶段。第五代移动通信、专网及低轨卫星通信的应用显著提升了远程操控的实时性与稳定性,为跨区域开展外科手术提供了重要技术基础。近年来,我国依托国产手术机器人平台,在多学科、多场景开展了远程手术探索,初步验证了其可行性与安全性。然而,与本地机器人手术相比,远程机器人手术在通信不确定性、双团队协作、并发症应急处置及培训体系等方面呈现新的风险特征,现有研究多为病例报道或小样本研究,循证证据仍有限。本文在梳理远程机器人手术关键技术与应用现状的基础上,分析其操作模式与风险结构特点,总结覆盖术前评估、术中安全控制、并发症处置及术后质量管理的安全实施框架,并探讨其规范化推广面临的主要挑战,以期为远程机器人手术的临床应用与后续研究提供参考。

    Abstract:

    With advances in communication technologies and surgical robotics, telerobotic surgery has gradually evolved from early feasibility demonstrations to exploratory clinical application. The implementation of fifth-generation mobile communication, dedicated networks, and low-Earth-orbit satellite communication has significantly improved the real-time performance and stability of remote manipulation, providing an essential technical foundation for cross-regional surgical practice. In recent years, China has accumulated growing experience in this field, with exploratory applications based on domestically developed robotic platforms across multiple surgical specialties, preliminarily demonstrating the feasibility and safety of telerobotic surgery. However, compared with local robotic surgery, telerobotic surgery presents distinct challenges, including communication uncertainty, dual-team coordination, emergency management of intraoperative complications, and limitations in current training systems. In addition, most available evidence is derived from case reports or small series, and the quality of evidence as well as the boundaries of clinical indications remain unclear. This article reviews the current technological and clinical progress in telerobotic surgery, analyzes its operational characteristics and risk structure, summarizes a safety-oriented implementation framework covering preoperative assessment, intraoperative safety control, complication management, and postoperative quality management, and discusses the major challenges for its standardized implementation.

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孙涵,蔡忠良,嵇武.远程机器人手术的现状、风险特征与安全实施框架[J].中国普通外科杂志,2026,35(2):376-383.
DOI:10.7659/j. issn.1005-6947.250671

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  • 收稿日期:2025-11-26
  • 最后修改日期:2026-02-15
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  • 在线发布日期: 2026-04-09