Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Urology. 2013 Dec;82(6):1300-3. doi: 10.1016/j.urology.2013.08.017. Epub 2013 Sep 21.
To investigate the feasibility of side-docking techniques in robot-assisted urologic pelvic surgery.
Six consecutive patients undergoing robot-assisted pelvic surgery participated in the study: 3 undergoing radical cystectomy for muscle-invasive bladder cancer, 1 patient undergoing ureteroneocystostomy for ureteric stricture, 1 patient undergoing partial cystectomy for urothelial cancer in a bladder diverticulum, and 1 undergoing transvesical simple prostatectomy. Each patient was placed in the lithotomy-Trendelenburg position, with the robot docked over the patient's right side.
All the procedures were completed without the need for redocking. Simultaneous cystourethroscopy was performed in 1 case to localize a bladder diverticular tumor during a partial cystectomy. Manipulation of the uterus and perineum was possible by the second assistant sitting between the patients' legs. No significant collision between the robotic arms occurred. There was no Clavien-Dindo III-V complication in any case.
Side docking for robot-assisted urologic pelvic surgery is a viable positioning alternative with the advantage of enhanced access to the perineum and urethra. This modified approach will be useful in robot-assisted radical cystectomy and other reconstructive urologic procedures.
探讨机器人辅助泌尿外科骨盆手术中侧方对接技术的可行性。
本研究纳入了 6 例连续接受机器人辅助骨盆手术的患者：3 例接受根治性膀胱切除术治疗肌层浸润性膀胱癌，1 例接受输尿管再吻合术治疗输尿管狭窄，1 例接受膀胱憩室尿路上皮癌部分切除术，1 例接受经膀胱单纯前列腺切除术。每位患者均取截石位-Trendelenburg 体位，机器人安装在患者右侧。
所有手术均无需重新对接即可完成。在 1 例部分膀胱切除术时，为定位膀胱憩室肿瘤，同时进行了膀胱镜检查。助手可坐在患者两腿之间，对子宫和会阴进行操作。机器人手臂之间没有发生明显碰撞。所有患者均未出现 Clavien-Dindo III-V 级并发症。
机器人辅助泌尿外科骨盆手术的侧方对接是一种可行的替代定位方法，具有增强对会阴和尿道的可达性的优势。这种改良方法将有助于机器人辅助根治性膀胱切除术和其他重建泌尿外科手术。
