Gynecologic Oncologic Unit, Department of Oncological Surgery, "Regina Elena" National Cancer Institute, Rome, Italy.
Ann Surg Oncol. 2013 Aug;20(8):2759-64. doi: 10.1245/s10434-013-2922-9. Epub 2013 Mar 7.
To evaluate the feasibility and the safety of robotic single-site hysterectomy (RSSH) in low risk early endometrial cancer.
Patients with clinical low risk early endometrial cancer were enrolled onto a prospective cohort trial. All surgical procedures were performed through a single 2-2.5 cm umbilical incision, with a multichannel system consisting of a five-lumen port providing access for two single-site instruments (da Vinci Si Surgical System, Intuitive Surgical, Sunnyvale, CA), the 8.5 mm 3D HD endoscope, a 5/10 mm accessory port, and an insufflation adaptor.
Between December 2011 and June 2012, a total of 17 patients were included in our pilot study. The median age of the patients was 64 years (range, 42-84 years), and median body mass index was 26.6 kg/m(2) (range, 18-52 kg/m(2)). One patient was excluded from the study as a result of pelvic metastasis during inspection of abdominal cavity, and another patient was converted to vaginal surgery as a result of problems of hypercapnia. The median docking time, console time, and total operative time was 8 min (range, 5-14 min), 48 min (range, 45-51 min), and 90 min (range, 70-147 min), respectively. The median blood loss was 75 mL (range, 50-150 mL). No laparoscopy/laparotomy conversion was registered. The median time to discharge was 2 days (range, 1-3 days). Neither intraoperative nor postoperative complications occurred. At a median of 7.5 months' follow-up, all patients were disease-free.
RSSH is technically feasible in patients affected by low risk early endometrial cancer. Additional studies with gynecologic oncologic cases should be performed to explore the possible benefits of RSSH.
评估机器人单部位子宫切除术（RSSH）在低危早期子宫内膜癌中的可行性和安全性。
临床低危早期子宫内膜癌患者入组前瞻性队列研究。所有手术均通过单个 2-2.5cm 脐部切口进行，采用多通道系统，包括一个五腔端口，为两个单部位器械（达芬奇 Si 外科系统，直觉外科公司，加利福尼亚州森尼韦尔）、8.5mm 3D HD 内窥镜、5/10mm 辅助端口和一个充气适配器提供通道。
2011 年 12 月至 2012 年 6 月，共有 17 例患者入组我们的初步研究。患者的中位年龄为 64 岁（范围，42-84 岁），中位体重指数为 26.6kg/m²（范围，18-52kg/m²）。1 例患者因腹部探查时发现盆腔转移而被排除在研究之外，另 1 例患者因高碳酸血症问题转为阴道手术。中位对接时间、控制台时间和总手术时间分别为 8 分钟（范围，5-14 分钟）、48 分钟（范围，45-51 分钟）和 90 分钟（范围，70-147 分钟）。中位出血量为 75ml（范围，50-150ml）。无腹腔镜/剖腹术中转。中位出院时间为 2 天（范围，1-3 天）。术中或术后均无并发症发生。中位随访 7.5 个月，所有患者均无疾病。
RSSH 对低危早期子宫内膜癌患者具有技术可行性。应开展更多妇科肿瘤病例的研究，以探索 RSSH 的可能益处。
