Giacomoni A, Di Sandro S, Lauterio A, Mangoni I, Mihaylov P, Concone G, Tripepi M, Poli C, Cusumano C, De Carlis L
Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy.
Transplant Proc. 2013 Sep;45(7):2627-31. doi: 10.1016/j.transproceed.2013.07.038.
Robot-assisted surgery provide endowrist instruments and 3-dimensional visualization of the operative field that are improvements over traditional laparoscopy. The few research studies published so far have demonstrated that living-donor nephrectomy using the robot-assisted technique is safe and feasible, providing advantages for patients.
Since November 2009, we performed 20 robot-assisted living-donor nephrectomies. Eight patients underwent hand-assisted robotic nephrectomy, whereas 20, totally robotic nephrectomy.
Median intraoperative bleeding was 174 mL (range, 10-750) but no patient needed intraoperative transfusion with blood cells. The median warm ischemia time was 3.16 minutes (range, 0.30-6.5). there was no case of conversion to an open procedure. The median operative time was 311 minutes (range, 85-530); the median console time was 160 minutes (range, 135-220).
Robot-assisted living-donor kidney recovery was a safe and effective procedure. The totally robotic recovery is an evolving technique. The prospect of robotic staplers, endowrist ligature, and robotic single port may further increase these advantages.
机器人辅助手术提供了腕关节活动器械和手术视野的三维可视化，相较于传统腹腔镜手术有了改进。迄今为止发表的少数研究表明，使用机器人辅助技术进行活体供肾肾切除术是安全可行的，对患者具有优势。
自2009年11月以来，我们进行了20例机器人辅助活体供肾肾切除术。8例患者接受了手辅助机器人肾切除术，而另外20例为完全机器人肾切除术。
术中出血中位数为174毫升（范围为10 - 750毫升），但没有患者需要术中输注血细胞。热缺血时间中位数为3.16分钟（范围为0.30 - 6.5分钟）。没有转为开放手术的病例。手术时间中位数为311分钟（范围为85 - 530分钟）；控制台操作时间中位数为160分钟（范围为135 - 220分钟）。
机器人辅助活体供肾切取术是一种安全有效的手术。完全机器人切取术是一种不断发展的技术。机器人吻合器、腕关节活动结扎术和机器人单孔手术的前景可能会进一步增强这些优势。
