Sonoda T, Lee S, Whelan R L, Le D, Foglia C, Venturero M, Hunt D, Nakajima K, Milsom J W
Section of Colon and Rectal Surgery, New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 East 68th Street, Box 172, New York, New York 10021, USA.
Surg Endosc. 2007 Dec;21(12):2220-3. doi: 10.1007/s00464-007-9337-2. Epub 2007 May 24.
Robotically assisted surgery offers the advantages of improved dexterity and elimination of tremor over conventional laparoscopic surgery. There have been few studies to date, however, examining the role of robotics in intestinal surgery. This study was undertaken to determine the feasibility and safety of using a robotic surgical system in the performance of intracorporeal small bowel strictureplasties in dogs.
Using a robotic surgical system, a total of 16 strictureplasties were performed in the small bowel of eight dogs (two strictureplasties per dog). Using only intracorporeal robotic surgery, a 2.5 cm enterotomy was made longitudinally in the small bowel, and then closed in a Heineke-Mikulicz configuration with a one-layer running 3-0 braided absorbable suture (strictureplasty). All animals were allowed to survive for 7 days with prospective monitoring of bowel movements, level of activity, oral intake, and abdominal examination. After 7 days, necropsy was performed, examining all strictureplasty sites for signs of sepsis. The endpoints of the study were recovery of normal intestinal function (bowel movements), intraoperative and postoperative complications, and the appearance of the anastomoses at necropsy.
There was no intraoperative morbidity or mortality. All eight dogs survived 7 days and recovered well. All dogs had a bowel movement on the first postoperative day, and appeared healthy throughout the study period. Necropsy revealed that all 16 strictureplasty sites were healing without signs of sepsis. The median time per strictureplasty was 65 min (range, 45-110 min). One dog developed a superficial wound infection at a trocar site.
A robotic surgical system can successfully be employed in the performance of intestinal strictureplasties in dogs. This study supports further investigation into the role of robotics in intestinal surgery in humans.
与传统腹腔镜手术相比，机器人辅助手术具有灵活性更高和可消除震颤的优势。然而，迄今为止，很少有研究探讨机器人技术在肠道手术中的作用。本研究旨在确定在犬体内进行小肠狭窄成形术时使用机器人手术系统的可行性和安全性。
使用机器人手术系统，在8只犬的小肠中总共进行了16次狭窄成形术（每只犬进行2次狭窄成形术）。仅采用体内机器人手术，在小肠上纵向切开一个2.5厘米的肠切口，然后采用海涅克-米库利兹（Heineke-Mikulicz）术式，用3-0编织可吸收缝线连续单层缝合关闭（狭窄成形术）。所有动物存活7天，对排便情况、活动水平、口服摄入量和腹部检查进行前瞻性监测。7天后，进行尸检，检查所有狭窄成形术部位是否有败血症迹象。研究的终点是肠道功能恢复正常（排便）、术中和术后并发症以及尸检时吻合口的外观。
术中无发病或死亡情况。所有8只犬均存活7天且恢复良好。所有犬在术后第一天都有排便，并且在整个研究期间看起来健康。尸检显示，所有16个狭窄成形术部位均在愈合，无败血症迹象。每个狭窄成形术的中位时间为65分钟（范围为45 - 110分钟）。1只犬在套管针部位发生了浅表伤口感染。
机器人手术系统可成功用于犬的肠道狭窄成形术。本研究支持进一步探讨机器人技术在人类肠道手术中的作用。
