Kandil Emad, Noureldine Salem I, Saggi Bob, Buell Joseph F
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
JSLS. 2013 Jan-Mar;17(1):56-62. doi: 10.4293/108680812X13517013317671.
Robotic-assisted surgery offers a solution to fundamental limitations of conventional laparoscopic surgery, and its use is gaining wide popularity. However, the application of this technology has yet to be established in hepatic surgery.
A retrospective analysis of our prospectively collected liver surgery database was performed. Over a 6-month period, all consecutive patients who underwent robotic-assisted hepatic resection for a liver neoplasm were included. Demographics, operative time, and morbidity encountered were evaluated.
A total of 7 robotic-assisted liver resections were performed, including 2 robotic-assisted single-port access liver resections with the da Vinci-Si Surgical System (Intuitive Surgical Sunnyvalle, Calif.) USA. The mean age was 44.6 years (range, 21-68 years); there were 5 male and 2 female patients. The mean operative time (± SD) was 61.4 ± 26.7 minutes; the mean operative console time (± SD) was 38.2 ± 23 minutes. No conversions were required. The mean blood loss was 100.7 mL (range, 10-200 mL). The mean hospital stay (± SD) was 2 ± 0.4 days. No postoperative morbidity related to the procedure or death was encountered.
Our initial experience with robotic liver resection confirms that this technique is both feasible and safe. Robotic-assisted technology appears to improve the precision and ergonomics of single-access surgery while preserving the known benefits of laparoscopic surgery, including cosmesis, minimal morbidity, and faster recovery.
机器人辅助手术为传统腹腔镜手术的根本局限性提供了解决方案,且其应用正日益普及。然而,该技术在肝脏手术中的应用尚未确立。
对前瞻性收集的肝脏手术数据库进行回顾性分析。在6个月期间,纳入所有连续接受机器人辅助肝肿瘤切除术的患者。评估患者的人口统计学资料、手术时间和所遇到的并发症。
共进行了7例机器人辅助肝切除术,其中包括2例使用美国达芬奇Si手术系统(直观外科公司,加利福尼亚州森尼韦尔市)的机器人辅助单孔入路肝切除术。平均年龄为44.6岁(范围21 - 68岁);男性5例,女性2例。平均手术时间(±标准差)为61.4 ± 26.7分钟;平均手术控制台时间(±标准差)为38.2 ± 23分钟。无需中转手术。平均失血量为100.7 mL(范围10 - 200 mL)。平均住院时间(±标准差)为2 ± 0.4天。未遇到与手术相关的术后并发症或死亡。
我们机器人肝切除的初步经验证实该技术既可行又安全。机器人辅助技术似乎提高了单孔入路手术的精确性和人体工程学性能,同时保留了腹腔镜手术的已知优势,包括美容效果、最小化并发症和更快恢复。