Department of General, Laparoscopic, Robotic & Bariatric Surgery, Athens Medical Center, Distomou 3-5, Marousi, 15125 Athens, Greece.
Surg Endosc. 2012 Sep;26(9):2687-94. doi: 10.1007/s00464-012-2227-2. Epub 2012 Apr 5.
The aim of this work was to study the feasibility, safety, and efficacy of single-incision robotic cholecystectomy using a novel platform from Intuitive Surgical.
All operations were performed by the same surgeon. Parameters assessed included patient history, indication for surgery, operation time, complication rate, conversion rate, robot-related issues, length of hospital stay, postoperative pain, and time to return to work. All patients were followed for a 2-month period postoperatively.
Forty-five patients (22 women, 23 men) underwent single-incision robotic cholecystectomy from March 1 to July 15, 2011. There were no conversions to either conventional laparoscopy or laparotomy, although in three cases a second trocar was used. There were no major complications apart from a single case of postoperative hemorrhage. Average patient age was 47 ± 12 years (range = 27-80 years) and average BMI was 30 kg/m(2) (mean = 28.8 ± 4 kg/m(2), range = 18.4-46.7 kg/m(2)). The primary indication for surgery was gallstones. The mean operation time (skin-to-skin) was 84.5 ± 25.5 min (range = 51-175 min), docking time was 5.8 ± 1.5 min (range = 4-11 min), and console time (net surgical time) was 43 ± 21.9 min (range = 21-121 min). Intraoperative blood loss was negligible. There were no collisions between the robotic arms and no other robot-related problems. Average postoperative length of stay was less than 24 h. The mean Visual Analog Pain Scale Score 6 h after the operation was 2.2 ± 1.51 (range = 0-6) and patients returned to normal activities in 4.48 ± 2.3 days (range = 1-9 days).
Single-Site(®) is a new platform offering a potentially more stable and reliable environment to perform single-port cholecystectomy. Both simple and complicated cholecystectomies can be performed with safety. The technique is possible in patients with a high BMI. The induction of pneumoperitoneum using the new port and the docking process require additional training.
本研究旨在探讨使用直观外科公司（Intuitive Surgical）的新型平台行单切口机器人胆囊切除术的可行性、安全性和疗效。
所有手术均由同一位外科医生完成。评估的参数包括患者病史、手术适应证、手术时间、并发症发生率、中转率、机器人相关问题、住院时间、术后疼痛和恢复工作时间。所有患者术后均随访 2 个月。
2011 年 3 月 1 日至 7 月 15 日，45 例患者（22 例女性，23 例男性）行单切口机器人胆囊切除术。无中转开腹或传统腹腔镜手术，尽管有 3 例患者使用了第二枚套管针。除 1 例术后出血外，无其他严重并发症。患者平均年龄为 47 ± 12 岁（范围=27-80 岁），平均 BMI 为 30 kg/m²（平均=28.8 ± 4 kg/m²，范围=18.4-46.7 kg/m²）。手术的主要适应证是胆囊结石。手术时间（皮肤至皮肤）平均为 84.5 ± 25.5 min（范围=51-175 min），安装时间为 5.8 ± 1.5 min（范围=4-11 min），控制台时间（实际手术时间）为 43 ± 21.9 min（范围=21-121 min）。术中出血量可忽略不计。机器人手臂之间无碰撞，无其他机器人相关问题。术后平均住院时间不到 24 h。术后 6 h 时平均视觉模拟疼痛评分（VAS）为 2.2 ± 1.51（范围=0-6），患者在 4.48 ± 2.3 天（范围=1-9 天）恢复正常活动。
单部位平台（Single-Site(®)）是一种新的平台，为实施单孔胆囊切除术提供了一个更稳定、更可靠的环境。该技术可安全应用于简单和复杂的胆囊切除术。在 BMI 较高的患者中也可实施该技术。使用新型端口建立气腹和安装机器人手臂需要额外的培训。
