Daher A, Renouvel F, Lauratet B, Guillot E, Lefranc J-P
Service de chirurgie et cancérologie gynécologique et mammaire, université Paris-6 - UPMC, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France.
J Gynecol Obstet Biol Reprod (Paris). 2013 Oct;42(6):570-6. doi: 10.1016/j.jgyn.2013.07.001. Epub 2013 Aug 22.
The aim of our study was to demonstrate the feasibility of the laparoscopic robot-assisted anterior and posterior mesh sacrocolpopexy compared to the laparoscopic approach.
Between November 2009 and August 2011, 36 women underwent sacrocolpopexy with anterior and posterior mesh, 16 by a robot-assisted approach and 20 by laparoscopy. The cases were systematically evaluated at 1 and 12 months postoperatively. All cases were contacted 6 months later to evaluate the functional results.
Both groups were comparable in terms of age, ASA score, Body Mass Index, surgical history and grades of pelvic organ prolapse preoperatively. There was no difference in terms of hospital stay, per- and postoperative complications, especially concerning the rate of postoperative constipation. The mean operating time was significantly more important in the Robot group (P=0.001) with 318 min for the Robot group versus 260 min for the laparoscopic group. With a mean follow-up of 12 months, the anatomic result was satisfactory without recurrence in 97.2% of the cases. The urinary and sexual results, the restart of a sexual activity postoperatively, the surgical satisfaction and the return to daily activities were comparable between both groups.
Robot-assisted laparoscopic sacrocolpopexy seems to be a reliable technique with morbidity, anatomic and functional outcomes comparable to that of laparoscopy.
我们研究的目的是证明与腹腔镜手术相比，腹腔镜机器人辅助前后路网片骶骨阴道固定术的可行性。
2009年11月至2011年8月期间，36名女性接受了前后路网片骶骨阴道固定术，其中16例采用机器人辅助手术，20例采用腹腔镜手术。术后1个月和12个月对病例进行系统评估。6个月后联系所有病例以评估功能结果。
两组在年龄、美国麻醉医师协会（ASA）评分、体重指数、手术史和术前盆腔器官脱垂分级方面具有可比性。住院时间、围手术期和术后并发症方面无差异，尤其是术后便秘发生率。机器人组的平均手术时间明显更长（P = 0.001），机器人组为318分钟，而腹腔镜组为260分钟。平均随访12个月，97.2%的病例解剖结果满意且无复发。两组在泌尿和性功能结果、术后恢复性生活、手术满意度以及恢复日常活动方面相当。
机器人辅助腹腔镜骶骨阴道固定术似乎是一种可靠的技术，其发病率、解剖和功能结果与腹腔镜手术相当。
