Laursen Henrik Blegvad, Thorsøe Hans Jakob, Funch-Jensen Peter, Rokkjaer Mogens, Yasuda Yoshikazu, Mortensen Frank Viborg
Department of Gastrointestinal Surgery L, Section AKH, Aarhus University Hospital, 8000, Aarhus C, Denmark.
J Hepatobiliary Pancreat Surg. 2005;12(2):167-72. doi: 10.1007/s00534-004-0964-x.
BACKGROUND/PURPOSE: We aimed to investigate the feasibility of robotic-assisted laparascopic reconstruction of the common bile duct (CBD) by way of Roux-en-Y choledochojejunostomy, given an operator with no prior robotic skills.
Ten pigs, of 75 kg median weight, were used for the experiments. Three of these animals were used to initialize and adjust the procedure, and seven were scheduled for postoperative survival of a week, and subsequent laparotomy for evaluation. The gallbladder was removed and a Roux-en-Y choledochojejunostomy was done. Blood samples were drawn prior to the first and the final operation. Under laparotomy, the animals were investigated for signs of cholascos and intraoperative cholangiography was performed.
All pigs showed competent anastomoses upon evaluation, including two pigs, which died on the fourth and fifth postoperative days, respectively, due to incorrect suspension of the Roux-en-Y sling, resulting in gastric retention. Standard liver parameters were not affected by surgery, and cholangiography showed no signs of extrahepatic stenosis or intrahepatic dilatation.
Robotic-assisted Roux-en-Y choledocho-jejunostomy is an easy procedure and accomplishes biliary drainage and intact intestinal flow. Decreasing operating times were experienced, approximating those of a skilled operator.
背景/目的：我们旨在探讨在操作者无机器人手术经验的情况下，通过机器人辅助腹腔镜行 Roux-en-Y 胆总管空肠吻合术重建胆总管的可行性。
选用 10 头猪，平均体重 75 千克用于实验。其中 3 头用于启动和调整手术流程，另外 7 头计划术后存活一周，随后进行剖腹手术评估。切除胆囊并进行 Roux-en-Y 胆总管空肠吻合术。在首次手术和最后一次手术前采集血样。剖腹手术时，检查动物有无胆汁渗漏迹象并进行术中胆管造影。
所有猪在评估时吻合口均良好，包括 2 头猪，分别在术后第 4 天和第 5 天因 Roux-en-Y 肠袢悬吊不当导致胃潴留而死亡。标准肝脏参数未受手术影响，胆管造影未显示肝外狭窄或肝内扩张迹象。
机器人辅助 Roux-en-Y 胆总管空肠吻合术操作简便，可实现胆汁引流和肠道通畅。手术时间逐渐缩短，接近熟练操作者的水平。
