Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Int J Urol. 2013 Feb;20(2):172-6. doi: 10.1111/j.1442-2042.2012.03127.x. Epub 2012 Aug 26.
Accurate tumor identification during partial nephrectomy is essential for successful tumor control. Intraoperative laparoscopic ultrasonography is useful for tumor localization, but the ultrasound probe is controlled by the assistant rather than the surgeon. We evaluated our initial experience using a robotic ultrasound probe that is controlled by the console surgeon.
Partial nephrectomy was carried out in 22 consecutive patients between November 2010 and March 2011. A robotic ultrasound probe under console surgeon control was used in all the cases. All patients had at least 1 year follow up.
Mean patient age was 59 years and mean tumor size was 2.7 cm. There were six hilar tumors (27%) and 21 (95%) endophytic tumors. Mean R.E.N.A.L. nephrometry score was 6.9 (range 6-9). Mean operative time was 205.7 min and mean warm ischemia time was 17.9 min (range 6-28 min). All patients had negative tumor margins and were free of disease recurrence at a mean follow up of 13 months.
The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure.
在部分肾切除术中准确识别肿瘤对于成功控制肿瘤至关重要。术中腹腔镜超声检查有助于肿瘤定位,但超声探头由助手控制,而非外科医生。我们评估了使用控制台外科医生控制的机器人超声探头的初步经验。
2010 年 11 月至 2011 年 3 月期间,连续 22 例患者接受了部分肾切除术。所有病例均使用控制台外科医生控制的机器人超声探头。所有患者均随访至少 1 年。
患者平均年龄为 59 岁,平均肿瘤大小为 2.7cm。有 6 例(27%)为肾门肿瘤,21 例(95%)为内生型肿瘤。平均 R.E.N.A.L. 肾脏解剖评分 6.9(范围 6-9)。平均手术时间为 205.7 分钟,平均热缺血时间为 17.9 分钟(范围 6-28 分钟)。所有患者的肿瘤切缘均为阴性,在平均 13 个月的随访中无疾病复发。
在部分肾切除术中使用机器人超声探头可让外科医生最大限度地自主优化肿瘤识别,并在部分肾切除术的这一关键步骤中受益于机器人仪器的精确性和灵活性。