Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea.
Surg Endosc. 2010 Nov;24(11):2755-9. doi: 10.1007/s00464-010-1040-z. Epub 2010 Apr 10.
Today, many kinds of surgery are being conducted without human assistants. Living donor nephrectomy (LDN) using video-assisted minilaparotomy surgery (VAM) has been performed by solo-surgeon using Unitrac® (Aesculap Surgical Instrument, Germany). We examined the results from VAM-solo-surgeon living donor nephrectomy (SLDN) and conventional VAM-human-assisted living donor nephrectomy (HLDN).
Between July 2007 and April 2008, 82 cases of VAM-LDN were performed by two surgeons. From these cases, we randomly assigned 35 cases to undergo solo-surgery (group I) and the other 47 cases to undergo surgery with one human assistant (group II). All VAM-LDN procedures were performed in the same manner. Only the roles of a first assistant were substituted by the Unitrac® in group I. We compared the perioperative and postoperative data, including operative time, estimated blood loss, and hospital stay, between the two groups. We also investigated cases that developed complications.
There were no significant differences in the patient demographic data between the two groups (P > 0.05). The mean operative time was 201.9 ± 32.9 min in group I and 202.4 ± 48.3 min in group II (P = 0.954), whereas mean blood loss was 209.7 ± 167.3 ml in group I and 179.6 ± 87.8 ml in group II (P = 0.294). Postoperative hospital stay were 5.4 ± 1.1 days in group I and 5.5 ± 1.6 days in group II (P = 0.813). The incidence of perioperative complications was not significantly different between the two groups.
Our study demonstrates that VAM-SLDN can be performed safely, is economically beneficial, and is comparable to VAM-HLDN in terms of postoperative outcomes.
如今，许多手术都无需人类助手即可进行。使用视频辅助小切口手术（VAM）的活体供肾切除术（LDN）已由单独的外科医生使用 Unitrac®（德国 Aesculap 外科器械公司）进行。我们检查了 VAM-单人手术活体供肾切除术（SLDN）和传统 VAM-人类辅助活体供肾切除术（HLDN）的结果。
在 2007 年 7 月至 2008 年 4 月期间，两位外科医生进行了 82 例 VAM-LDN。从这些病例中，我们随机将 35 例分配为单人手术组（I 组），其余 47 例分配为有一名人类助手的手术组（II 组）。所有 VAM-LDN 手术均以相同的方式进行。只有第一助手的角色在 I 组中被 Unitrac®替代。我们比较了两组患者的围手术期和术后数据，包括手术时间、估计失血量和住院时间。我们还调查了发生并发症的病例。
两组患者的人口统计学数据无显著差异（P>0.05）。I 组的平均手术时间为 201.9±32.9 分钟，II 组为 202.4±48.3 分钟（P=0.954），而 I 组的平均失血量为 209.7±167.3 毫升，II 组为 179.6±87.8 毫升（P=0.294）。I 组的术后住院时间为 5.4±1.1 天，II 组为 5.5±1.6 天（P=0.813）。两组围手术期并发症发生率无显著差异。
我们的研究表明，VAM-SLDN 可以安全进行，在经济上有利，并且在术后结果方面与 VAM-HLDN 相当。
