智能治疗机器人辅助手术是精准肿瘤学的下一个前沿

摘要(中文译文)

机器人辅助手术在过去二十年中已从机械辅助腹腔镜演变为日益智能化、具有生物响应性的治疗模式。早期机器人系统主要增强了灵活性和可视化能力，而当代平台现已整合人工智能、先进成像、实时生物传感和药理学接口，使手术能力超越单纯的物理操作。因此，机器人辅助手术正崛起于数字智能与分子医学的交汇点，具有在手术干预过程中感知、解读和调控肿瘤生物学的潜力。然而，当前文献仍主要以手术流程为中心并聚焦于机械层面，对机器人系统如何与药理学、人工智能和系统医学融合以主动调控肿瘤学过程缺乏系统综合。一个将智能机器人与术中药物递送及实时生物反馈相结合、以肿瘤学为导向的连贯框架明显缺失。本叙述性综述批判性地整合了药理学赋能机器人平台、人工智能驱动的术中认知以及新兴闭环手术-药理学架构方面的最新进展。本文审视了整合局部药物递送、分子诊断和实时药效动力学监测的新一代系统，同时讨论了塑造半自主肿瘤学生态系统的转化路径和监管考量。通过将机器人辅助手术重新定义为动态治疗科学而非纯粹的机械工具，本综述凸显了精准肿瘤学的一个新前沿，其有望实现个体化、自适应和预测性的癌症干预。

Abstract

Robotic-assisted surgery has evolved over the past two decades from mechanically assisted laparoscopy into an increasingly intelligent, biologically responsive therapeutic modality. While early robotic systems primarily enhanced dexterity and visualization, contemporary platforms now integrate artificial intelligence, advanced imaging, real-time biosensing, and pharmacological interfaces, extending surgical capability beyond physical manipulation alone. Robotic-assisted surgery is thus emerging at the intersection of digital intelligence and molecular medicine, with the potential to sense, interpret, and modulate tumor biology during operative intervention. However, current literature remains largely procedure-centered and mechanically focused, offering limited synthesis of how robotic systems converge with pharmacology, artificial intelligence, and systems medicine to actively regulate oncologic processes. A cohesive, oncology-oriented framework integrating intelligent robotics with intraoperative drug delivery and real-time biological feedback is notably lacking. This narrative review critically consolidates recent advances in pharmacologically enabled robotic platforms, AI-driven intraoperative cognition, and emerging closed-loop surgical-pharmacological architectures. It examines next-generation systems incorporating localized drug delivery, molecular diagnostics, and real-time pharmacodynamic monitoring, while discussing translational pathways and regulatory considerations shaping semi-autonomous oncologic ecosystems. By reframing robotic-assisted surgery as a dynamic therapeutic science rather than a purely mechanical tool, this review highlights a new frontier in precision oncology that has the potential to enable individualized, adaptive, and predictive cancer interventions.

如何引用

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