Robotics represents the most technologically advanced approach in minimally invasive surgery (MIS). Its application in general surgery has increased progressively, with some early experience reported in emergency settings. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a systematic review of the literature to develop consensus statements about the potential use of robotics in emergency general surgery. This position paper was conducted according to the WSES methodology. A steering committee was constituted to draft the position paper according to the literature review. An international expert panel then critically revised the manuscript. Each statement was voted through a web survey to reach a consensus. Ten studies (3 case reports, 3 case series, and 4 retrospective comparative cohort studies) have been published regarding the applications of robotics for emergency general surgery procedures. Due to the paucity and overall low quality of evidence, 6 statements are proposed as expert opinions. In general, the experts claim for a strict patient selection while approaching emergent general surgery procedures with robotics, eventually considering it for hemodynamically stable patients only. An emergency setting should not be seen as an absolute contraindication for robotic surgery if an adequate training of the operating surgical team is available. In such conditions, robotic surgery can be considered safe, feasible, and associated with surgical outcomes related to an MIS approach. However, there are some concerns regarding the adoption of robotic surgery for emergency surgeries associated with the following: (i) the availability and accessibility of the robotic platform for emergency units and during night shifts, (ii) expected longer operative times, and (iii) increased costs. Further research is necessary to investigate the role of robotic surgery in emergency settings and to explore the possibility of performing telementoring and telesurgery, which are particularly valuable in emergency situations. Many hospitals are currently equipped with a robotic surgical platform which needs to be implemented efficiently. The role of robotic surgery for emergency procedures remains under investigation. However, its use is expanding with a careful assessment of costs and timeliness of operations. The proposed statements should be seen as a preliminary guide for the surgical community stressing the need for reevaluation and update processes as evidence expands in the relevant literature.

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紧急情况下的机器人手术：2021 WSES 立场文件

机器人技术代表了微创手术 (MIS) 中技术最先进的方法。它在普通外科的应用逐渐增加，在紧急情况下报告了一些早期经验。本立场文件由世界急诊外科学会 (WSES) 支持，旨在对文献进行系统回顾，以就机器人在急诊普通外科手术中的潜在用途达成共识。本立场文件是根据 WSES 方法编写的。成立了一个指导委员会，根据文献回顾起草立场文件。一个国际专家小组随后对手稿进行了批判性修改。每个声明都通过网络调查进行投票，以达成共识。十项研究（3 个案例报告，3 个案例系列，和 4 个回顾性比较队列研究）已发表关于机器人在急诊普通外科手术中的应用。由于证据的缺乏和总体质量低，提出了 6 项陈述作为专家意见。一般来说，专家们声称在使用机器人进行紧急普通外科手术时会严格选择患者，最终只考虑对血流动力学稳定的患者。如果可以对手术手术团队进行充分培训，则不应将紧急情况视为机器人手术的绝对禁忌症。在这种情况下，机器人手术可以被认为是安全、可行的，并且与与 MIS 方法相关的手术结果相关。然而，对于紧急手术采用机器人手术存在一些担忧，与以下相关：(i) 机器人平台在急诊室和夜班期间的可用性和可及性，(ii) 预期更长的手术时间，以及 (iii) 增加费用。需要进一步的研究来调查机器人手术在紧急情况下的作用，并探索在紧急情况下特别有价值的远程指导和远程手术的可能性。目前，许多医院都配备了需要高效实施的机器人手术平台。机器人手术在紧急程序中的作用仍在调查中。然而，随着对成本和运营及时性的仔细评估，它的使用正在扩大。