Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Int J Med Robot. 2013 Sep;9(3):339-44. doi: 10.1002/rcs.1480. Epub 2013 Jan 2.
This work assessed the role of robotic-assisted lapararoscopic radical hysterectomy in the treatment of early invasive cervical cancer with special regard to nerve sparing technique.
Between October 2009 and June 2011, a total of 14 non-consecutive patients underwent early cervical cancer surgery at the authors' institution. Patients with FIGO stage IA2 or IB1 with a tumor size less than or equal to 2 cm underwent radical hysterectomy type B1 and patients with FIGO stage IB1 with a tumor mass bigger than 2 cm underwent a radical hysterectomy using a C1 type technique.
Three type B1 and 11 type C1 radical hysterectomies with robotic-assisted laparoscopy were performed using Da Vinci®. The median operation time was 260 min (range 150-300 min). The median follow-up after surgery was 13.7 months (range 1-23 months). During this time, three patients reported anorectal dysfunction while none reported sexual or bladder dysfunction. All patients remain without evidence of disease except one with high risk factors for recurrence. They all are alive.
Laparoscopic robotic-assisted radical hysterectomy with nerve sparing technique is an attractive surgical approach for early invasive cervical cancer. Robotic technology allows a stereoscopic visualization of blood vessels and autonomic nerve supplies (sympathetic and parasympathetic branches) to the bladder and rectum making nerve sparing a safe and feasible procedure.
本研究评估了机器人辅助腹腔镜根治性子宫切除术在早期浸润性宫颈癌治疗中的作用，特别关注保留神经技术。
2009 年 10 月至 2011 年 6 月，共有 14 例非连续患者在作者所在机构接受早期宫颈癌手术。FIGO 分期为 IA2 或 IB1 期且肿瘤大小小于或等于 2cm 的患者行 B1 型根治性子宫切除术，FIGO 分期为 IB1 期且肿瘤体积大于 2cm 的患者行 C1 型根治性子宫切除术。
共进行了 3 例 B1 型和 11 例 C1 型机器人辅助腹腔镜根治性子宫切除术。中位手术时间为 260 分钟（范围 150-300 分钟）。中位术后随访时间为 13.7 个月（范围 1-23 个月）。在此期间，有 3 例患者报告出现肛肠功能障碍，而无 1 例患者报告出现性功能或膀胱功能障碍。除 1 例具有复发高危因素的患者外，所有患者均无疾病证据。他们均存活。
保留神经的腹腔镜机器人辅助根治性子宫切除术是早期浸润性宫颈癌的一种有吸引力的手术方法。机器人技术可以立体可视化血管和自主神经供应（膀胱和直肠的交感和副交感分支），使保留神经成为一种安全可行的手术。
