Falcone T, Goldberg J, Garcia-Ruiz A, Margossian H, Stevens L
Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Ohio, USA.
J Laparoendosc Adv Surg Tech A. 1999 Feb;9(1):107-13. doi: 10.1089/lap.1999.9.107.
Optical magnification and long instrumentation significantly increase surgical tremor, which makes laparoscopic microsuturing difficult. Therefore, laparoscopic tubal anastomosis has not gained wide acceptance among gynecologic surgeons. Robotic assistance facilitates this type of procedure by filtering tremor, reducing the surgeon's fatigue, and scaling the maneuvers. The authors have successfully completed a case of laparoscopic tubal reanastomosis using a "master-slave" robot to perform the standard microsuturing technique. A 33-year-old woman, gravida 2, para 2, requested reversal of her previous tubal ligature. A right isthmic-isthmic tubal anastomosis was performed laparoscopically, with faithful adherence to the authors' standard technique applied at laparotomy. Full robotic assistance was used to anastomose the tube. A chromotubation test showed anastomotic patency without leak. The patient recovered uneventfully after surgery and was discharged within 24 h after the procedure. Laparoscopic microsurgical tubal anastomosis with full robotic assistance is feasible and safe in humans.
光学放大和长器械显著增加手术震颤，这使得腹腔镜显微缝合变得困难。因此，腹腔镜输卵管吻合术在妇科外科医生中尚未得到广泛认可。机器人辅助通过过滤震颤、减轻外科医生的疲劳以及缩放操作来促进这类手术。作者成功完成了一例使用“主从”机器人进行标准显微缝合技术的腹腔镜输卵管再吻合术。一名33岁、孕2产2的女性要求解除先前的输卵管结扎。腹腔镜下进行了右侧峡部-峡部输卵管吻合术，严格遵循作者在剖腹手术中应用的标准技术。使用全机器人辅助进行输卵管吻合。美蓝通液试验显示吻合口通畅无渗漏。患者术后恢复顺利，术后24小时内出院。全机器人辅助的腹腔镜显微外科输卵管吻合术在人体中是可行且安全的。
