Baldassarre Emanuele, Marcangeli Paolo, Vigano Massimo, Vittoria Ivano, Pone Domenico, Gillo Arianna, Pierini Paolo
Division of Urology, Umberto Parini Hospital, Aosta, Italy.
Arch Ital Urol Androl. 2011 Sep;83(3):160-2.
We found only a recent report of robotic-assisted nephropexy, in a young female with associated dismembered pyeloplasty. Herein we present the first case of isolated robotic nephropexy. A 34-year old female was referred to our Urological Division history of right flank pain and evidence at intravenous urography of a 5-6 cm descent of right kidney moving from supine to erect position. The robotic nephropexy was performed with a transperitoneal approach and 4 trocars. The kidney was wrapped up with a Parietex Composite (PCO) mesh (Tyco Healthcare), previously precut in an hockey stick shape to obtain a "spoon effect" to push up the lower pole of kidney. Despite the laparoscopic or retroperitoneoscopic procedures, the robotic-assisted nephropexy appears easier, with the particular advantages of the intracorporeal suturing and a better intraoperative view. The use of mesh, in our opinion, is preferable respect the decapsulation of the kidney, to avoid unnecessary blood loss and possible scarring.
我们仅发现一篇关于机器人辅助肾固定术的近期报道,该病例为一名年轻女性,同时合并有离断性肾盂成形术。在此,我们呈现首例单纯机器人肾固定术病例。一名34岁女性因右侧胁腹疼痛就诊于我院泌尿外科,静脉肾盂造影显示右肾在从仰卧位到直立位时下降了5 - 6厘米。机器人肾固定术采用经腹途径及4个套管针进行。肾脏用帕里泰克斯复合(PCO)网片(泰科医疗)包裹,该网片预先剪成曲棍球棒形状以获得“匙形效应”来上推肾下极。尽管有腹腔镜或后腹腔镜手术,但机器人辅助肾固定术似乎更简便,具有体内缝合以及术中视野更好的独特优势。我们认为,与肾被膜剥除术相比,使用网片更可取,可避免不必要的失血和可能的瘢痕形成。