Bot-Robin V, Rubod C, Zini L, Collinet P
Pôle de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, Lille cedex, France.
Gynecol Obstet Fertil. 2011 Jul-Aug;39(7-8):407-11. doi: 10.1016/j.gyobfe.2011.05.002. Epub 2011 Jul 13.
Preliminary study of the feasibility of robot-assisted laparoscopy for deep pelvic endometriosis nodule resection.
Between May 2009 and February 2010, we collected medical and surgical data about deep infiltrating endometriosis resections performed in our institution, using robot-assisted laparoscopy (DA VINCI Intuitive Surgical System(®)).
Six patients were included: four partial bladder and two uterosacral ligament resections. The median age was 29.5 years (24-48). All patients reported chronic pelvic pain, associated with urinary tract symptoms in case of bladder endometriosis. Before surgery, lesion mapping was performed using magnetic resonance imaging for all, and mechanical bowel preparation or double-j stenting were prescribed, depending on the endometriosis location. Surgical procedures median time was 173 minutes (156-244), and median length of stay was 3 days (2-5). Complete resection was possible in all cases. There was no conversion in classical laparoscopy or laparotomy, and no intraoperative complication. Pathology diagnosis of surgical pieces concluded to endometriosis lesion in all cases.
This study shows the feasibility of the robot-assisted laparoscopy in the resection of deep pelvic endometriosis, without increasing of surgical timing, blood loss or intraoperative complications.
机器人辅助腹腔镜手术用于深部盆腔子宫内膜异位症结节切除可行性的初步研究。
2009年5月至2010年2月期间,我们收集了在本机构使用机器人辅助腹腔镜手术(达芬奇直观手术系统(®))进行深部浸润性子宫内膜异位症切除术的医疗和手术数据。
纳入6例患者:4例行部分膀胱切除术,2例行子宫骶韧带切除术。中位年龄为29.5岁(24 - 48岁)。所有患者均有慢性盆腔疼痛,膀胱子宫内膜异位症患者伴有泌尿系统症状。术前,所有患者均采用磁共振成像进行病灶定位,并根据子宫内膜异位症的位置进行机械肠道准备或双J管置入。手术操作中位时间为173分钟(156 - 244分钟),中位住院时间为3天(2 - 5天)。所有病例均可行完整切除。未转为传统腹腔镜手术或开腹手术,无术中并发症。手术标本的病理诊断均为子宫内膜异位症病变。
本研究表明机器人辅助腹腔镜手术用于深部盆腔子宫内膜异位症切除具有可行性,且不增加手术时间、失血量或术中并发症。