Texas Institute for Robotic Surgery and Austin Diagnostic Clinic, Austin, TX, USA.
Int J Med Robot. 2013 Sep;9(3):365-70. doi: 10.1002/rcs.1507. Epub 2013 May 2.
Single-incision surgery has gained in popularity, and the recent development of specialized robotic and laparoscopic instruments may remove some of the ergonomic and technical difficulties associated with this approach. However, questions of cost and efficiency remain.
We prospectively collected perioperative outcome and efficiency (operative time, case volume) data for our single-site robotic cholecystectomy cases and retrospectively reviewed data for our single-incision laparoscopic cholecystectomy cases.
There were no differences in patient characteristics or perioperative outcomes between the robotic (n = 20) and laparoscopic (n = 10) groups; operative times were equivalent (84.6 vs 85.5 min; p = 0.8737) and blood loss and complications were minimal. There was a higher robotic case volume, with an average of two robotic cases (range 1-4)/day vs one/day for laparoscopic cases (range 1-1; p = 0.0306). Streamlined instrument costs were essentially equivalent.
Robotic single-site cholecystectomy is a safe, cost-effective alternative to single-incision laparoscopic cholecystectomy in a robot-existing model.
单切口手术越来越受欢迎,最近专门的机器人和腹腔镜器械的发展可能会消除与这种方法相关的一些人体工程学和技术困难。然而,成本和效率问题仍然存在。
我们前瞻性地收集了单部位机器人胆囊切除术的围手术期结果和效率(手术时间、病例量)数据,并回顾性地分析了单切口腹腔镜胆囊切除术的数据。
机器人组(n=20)和腹腔镜组(n=10)患者的特征和围手术期结果无差异;手术时间相当(84.6 分钟 vs 85.5 分钟;p=0.8737),出血量和并发症很少。机器人的手术量更高,平均每天有两例机器人手术(范围 1-4 例/天),而腹腔镜手术每天一例(范围 1-1 例/天;p=0.0306)。简化的器械成本基本相当。
在机器人现有模型中,机器人单部位胆囊切除术是一种安全、具有成本效益的单切口腹腔镜胆囊切除术替代方法。