呼吸器外科における3D胸腔鏡手術・ロボット支援手術

Three-dimensional （3D）-Video-assisted Thoracic Surgery （VATS） and Robot-assisted Thoracic Surgery （RATS）

われわれは2012年に本邦で開発された3D内視鏡システムを導入し，世界で最初の3D胸腔鏡肺葉切除（3D-VATS-lobectomy）を経験した．その後3D縦隔腫瘍摘出術，3D単孔式縦隔腫瘍摘出術を施行してきた．さらに，2018年4月からロボット支援手術（RATS）が呼吸器外科領域では肺癌，縦隔腫瘍手術に保険適用となり，われわれは2018年11月からロボット支援手術を肺癌，縦隔腫瘍（良性・悪性）に開始した．現在では国内でも急速に手術症例が増加しつつある．3D内視鏡システム，ロボット支援手術のメリット，デメリットを中心に報告する．

We firstly introduced a 3-dimensional system ［3D-video-assisted thoracic surgery （VATS）］ to the world in 2012, and have since performed 3D-VATS-lobectomy. From March 2012 to October 2019, 224 patients for lung cancer were treated by 3D-VATS. Since then, we have added resection of mediastinal tumors and 3D-uniportal-VATS. One of the advantages of the 3D-VATS is the spatial depth. The disadvantages are a bad mood and dizziness. Since the introduction of robot-assisted thoracic surgery （RATS） in April 2018, its use has become widespread, even in Japan. RATS has the potential for enormous growth in the future. To avoid any risk of surgery, safety measures are important to the team from around the day.

In the near future, there will be a distinction between robotic surgery and 2D, 3D-VATS.