Guillonneau B, Cappèle O, Martinez J B, Navarra S, Vallancien G
Department of Urology, Institut Mutualiste Montsouris, University Pierre and Marie Curie, Paris, France.
J Urol. 2001 Apr;165(4):1078-81.
We evaluate the feasibility and efficacy of robotic assisted, laparoscopic pelvic lymph node dissection for locally advanced prostate cancer staging.
Robotic assisted, laparoscopic pelvic lymph node dissection was performed in 10 consecutive patients with mainly T3 M0 prostatic carcinoma (robotic group). Operative, postoperative and pathological parameters were compared with the results of the last 10 patients undergoing conventional, laparoscopic pelvic lymph node dissection performed with similar indications by the same operator (laparoscopy group).
All operations were performed according to the established protocol with no specific intraoperative or postoperative complications. No conversion was required, and no technical incidents were observed in the robotic group. Mean operating time plus or minus standard deviation for the robotic group was 125 +/- 57 minutes (range 75 to 215), significantly longer than that for the laparoscopy group, which was 60 +/- 15 minutes (p = 0.0013). In the robotic group 2 patients presented with postoperative lymphoceles revealed in 1 by deep venous thrombosis and in the second by obturator pain. In the laparoscopy group 1 patient presented with acute urinary retention. The histological results concerning the number of lymph nodes removed were similar in both groups (p = 0.5).
We show the technical feasibility of robotic assisted, laparoscopic pelvic lymph node dissection in humans. Although the benefit of this technique has not yet been established, predictable technological improvements would suggest the development of telesurgery and an improved precision of surgical procedure.
我们评估机器人辅助腹腔镜盆腔淋巴结清扫术用于局部晚期前列腺癌分期的可行性和疗效。
对10例主要为T3 M0前列腺癌的连续患者实施机器人辅助腹腔镜盆腔淋巴结清扫术（机器人组）。将手术、术后及病理参数与同一操作者对具有相似指征的最后10例接受传统腹腔镜盆腔淋巴结清扫术的患者（腹腔镜组）的结果进行比较。
所有手术均按照既定方案进行，无特定的术中或术后并发症。机器人组无需中转，未观察到技术事故。机器人组平均手术时间（±标准差）为125±57分钟（范围75至215分钟），显著长于腹腔镜组的60±15分钟（p = 0.0013）。机器人组有2例患者出现术后淋巴囊肿，1例伴有深静脉血栓形成，另1例伴有闭孔疼痛。腹腔镜组有1例患者出现急性尿潴留。两组切除淋巴结数量的组织学结果相似（p = 0.5）。
我们展示了机器人辅助腹腔镜盆腔淋巴结清扫术在人体中的技术可行性。尽管该技术的益处尚未确立，但可预见的技术改进表明远程手术的发展以及手术操作精度的提高。
