机器人辅助腹腔镜输尿管松解术：微创外科手术方法的病例报告及文献综述

Robot-assisted laparoscopic ureterolysis: case report and literature review of the minimally invasive surgical approach.

作者信息

Seixas-Mikelus Stéfanie A, Marshall Susan J, Stephens D Dawon, Blumenfeld Aaron, Arnone Eric D, Guru Khurshid A

机构信息

Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.

出版信息

JSLS. 2010 Apr-Jun;14(2):313-9. doi: 10.4293/108680810X12785289145088.

DOI:10.4293/108680810X12785289145088

PMID:20932393

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3043593/

Abstract

OBJECTIVES

To evaluate our case of robot-assisted ureterolysis (RU), describe our surgical technique, and review the literature on minimally invasive ureterolysis.

METHODS

One patient managed with robot-assisted ureterolysis for idiopathic retroperitoneal fibrosis was identified. The chart was analyzed for demographics, operative parameters, and immediate postoperative outcome. The surgical technique was assessed and modified. Lastly, a review of the published literature on ureterolysis managed with minimally invasive surgery was performed.

RESULTS

One patient underwent robot-assisted ureterolysis at our institution in 2 separate settings. Operative time (OR) decreased from 279 minutes to 191 minutes. Estimated blood loss (EBL) was less than 50 mL. The patient has been free of symptoms and both renal units are unobstructed. According to the published literature, 302 renal units underwent successful laparoscopic ureterolysis (LU), and 6 renal units underwent RU. There were 9 open conversions (all in LU). Mean OR in LU was 248 minutes for unilateral and 386 minutes for bilateral cases. In RU, mean OR was 220 minutes for unilateral and 390 minutes for bilateral cases. EBL averaged 200 mL in LU and 30 mL in RU.

CONCLUSIONS

Our data reveal that robot-assisted ureterolysis is safe and feasible. Published data demonstrate the advantages of minimally invasive surgery.

摘要

目的

评估我们的机器人辅助输尿管松解术（RU）病例，描述我们的手术技术，并回顾微创输尿管松解术的相关文献。

方法

确定1例接受机器人辅助输尿管松解术治疗特发性腹膜后纤维化的患者。分析病历中的人口统计学资料、手术参数和术后即刻结果。评估并改进手术技术。最后，对已发表的关于微创治疗输尿管松解术的文献进行回顾。

结果

1例患者在我们机构分2次接受了机器人辅助输尿管松解术。手术时间（OR）从279分钟降至191分钟。估计失血量（EBL）少于50毫升。患者无症状，双肾单位均无梗阻。根据已发表的文献，302个肾单位成功接受了腹腔镜输尿管松解术（LU），6个肾单位接受了RU。有9例转为开放手术（均为LU）。LU单侧手术的平均OR为248分钟，双侧手术为386分钟。RU单侧手术的平均OR为220分钟，双侧手术为390分钟。LU的平均EBL为200毫升，RU为30毫升。