Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
J Endourol. 2012 Aug;26(8):971-4. doi: 10.1089/end.2011.0573. Epub 2012 Apr 17.
Conventional laparoscopic dismembered pyeloplasty (LP) is an established alternative to open pyeloplasty given equivalent intermediate-term outcomes and decreased morbidity. Laparoendoscopic single-site (LESS) pyeloplasty has the potential to further decrease the morbidity of LP, while yielding superior cosmesis. It is, however, technically very challenging even with the use of an accessory port, largely because of the difficulty of intracorporeal suturing through a single umbilical incision. Application of the da Vinci robotic surgical platform to LESS pyeloplasty (R-LESS) has the potential to overcome these limitations. We describe our technique for R-LESS pyeloplasty using the da Vinci Si robot. We have found that use of the robotic system in conjunction with certain technique modifications helps to reduce the technical difficulty of LESS pyeloplasty and to shorten the physical learning curve associated with the procedure.
传统腹腔镜离断肾盂成形术(LP)是一种成熟的替代开放肾盂成形术的方法,具有等效的中期结果和降低的发病率。经脐单部位腹腔镜手术(LESS)肾盂成形术有可能进一步降低 LP 的发病率,同时获得更好的美容效果。然而,即使使用辅助端口,它在技术上也极具挑战性,主要是因为通过单个脐部切口进行腔内缝合非常困难。达芬奇机器人手术平台在 LESS 肾盂成形术中的应用(R-LESS)有可能克服这些限制。我们描述了使用达芬奇 Si 机器人进行 R-LESS 肾盂成形术的技术。我们发现,机器人系统与某些技术改进一起使用有助于降低 LESS 肾盂成形术的技术难度,并缩短与该手术相关的物理学习曲线。