Vasilescu C
Centrul de Chirurgie Generală si Transplant Hepatic, Institutul Clinic de Boli Digestive si Transplant Hepatic Fundeni, Bucureşti.
Chirurgia (Bucur). 2010 Jan-Feb;105(1):83-7.
Until now 40 robotic splenectomies were performed in our department, the first case being done on February 25, 2008. Our data show that robotic splenectomy with the DaVinci surgical system is technically feasible and safe, with good results and without complications. The main advantages are a better tridimensional view and an increased versatility of the surgical instruments. The DaVinci system allows an accurate dissection around the splenic hilum and preservation of the splenic remnant vessels in partial splenectomy. Robotic splenectomy will probably not replace the laparoscopic splenectomy for the most common indications like ITP, hemolytic anemia. It may be a very useful surgical tool in difficult splenectomy: partial splenectomy, splenectomy in liver cirrhosis, splenic tumors or malignant hemopathies. In these cases the robotic approach may shorten the operative time, decrease the blood loss and the risk of remorrhagic complications during surgery and even make possible a minimally invasive splenectomy very difficult to be performed by classical laparoscopy.
截至目前，我们科室已完成40例机器人脾切除术，首例于2008年2月25日实施。我们的数据表明，使用达芬奇手术系统进行机器人脾切除术在技术上是可行且安全的，效果良好且无并发症。主要优点是具有更好的三维视野以及手术器械的多功能性增强。达芬奇系统能够在脾门周围进行精确解剖，并在部分脾切除术中保留脾残余血管。对于特发性血小板减少性紫癜、溶血性贫血等最常见的适应证，机器人脾切除术可能不会取代腹腔镜脾切除术。在困难的脾切除术中，如部分脾切除术、肝硬化患者的脾切除术、脾肿瘤或恶性血液病的脾切除术，它可能是一种非常有用的手术工具。在这些情况下，机器人手术方法可能会缩短手术时间，减少术中失血和再出血并发症的风险，甚至使传统腹腔镜很难实施的微创脾切除术成为可能。
