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机器人辅助腹腔镜单部位手术:肾恶性肿瘤的部分肾切除术。

Robot-assisted laparoendoscopic single-site surgery: partial nephrectomy for renal malignancy.

机构信息

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Urology. 2011 Mar;77(3):612-6. doi: 10.1016/j.urology.2010.06.067. Epub 2010 Nov 10.

Abstract

OBJECTIVES

To describe our experience with robot-assisted laparoendoscopic single-site surgery (LESS) to perform partial nephrectomy and evaluate a hybrid homemade port system as an effective access technique.

METHODS

From December 2008 to September 2009, robot-assisted LESS to perform partial nephrectomy through a hybrid homemade port was performed to treat 14 cases of renal cell carcinoma. The data, including patient characteristics, operative records, complications, and pathologic results, were analyzed.

RESULTS

The mean tumor size was 3.2 cm, the mean ischemic time was 30 minutes, and the mean operative time was 233 minutes. We used the hybrid homemade port technique in 10 cases. All surgical margins after partial nephrectomy were negative for malignancy. No port-related complications were reported. Two cases required conversion to mini-incisional partial nephrectomy.

CONCLUSIONS

Robot-assisted LESS for performing partial nephrectomy using a hybrid homemade port system is a safe and feasible treatment technique. It provided access for meticulous suturing on the renal parenchyma using articulating robot arms and ready access to the surgical field for the assistant.

摘要

目的

描述我们使用机器人辅助腹腔镜单部位手术(LESS)进行部分肾切除术的经验,并评估一种混合自制端口系统作为有效的进入技术。

方法

自 2008 年 12 月至 2009 年 9 月,我们使用机器人辅助 LESS 通过混合自制端口进行部分肾切除术治疗 14 例肾细胞癌。分析了包括患者特征、手术记录、并发症和病理结果在内的数据。

结果

肿瘤平均大小为 3.2cm,平均缺血时间为 30 分钟,平均手术时间为 233 分钟。我们在 10 例患者中使用了混合自制端口技术。所有部分肾切除术后的手术切缘均无恶性肿瘤。无与端口相关的并发症发生。有 2 例需要转为小切口部分肾切除术。

结论

使用混合自制端口系统进行机器人辅助 LESS 部分肾切除术是一种安全可行的治疗技术。它为使用铰接机器人手臂在肾实质上进行精细缝合提供了通道,并为助手提供了进入手术区域的便利。

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