Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2013 Dec;76(12):724-6. doi: 10.1016/j.jcma.2013.08.001. Epub 2013 Sep 27.
During the past few years, robotic surgical systems have been rapidly developed. The progress and advantages of these systems include three-dimensional vision and enhanced ergonomics. These advantages have helped a new generation of minimally invasive surgery to evolve. The da Vinci Surgical System seems to greatly resolve problems (e.g., wide exposure and retraction of peritoneal organs) that are confronted by traditional laparoscopic surgeries for retroperitoneal tumors that are near great vessels. There have been few reported cases concerning laparoscopic excision of retroperitoneal tumors situated between the inferior vena cava, the right renal vessel, and the kidney. We report the use of a robotic surgical system for this type of treatment. A 54-year-old female patient had a hypoechoic lesion near the inferior vena cava and superior to the right renal vessels. It was incidentally found by ultrasound during a health check-up examination. The computed tomography (CT) scan revealed a heterogeneous contrast-enhanced retroperitoneal mass approximately 4.4 cm medial to the right kidney with the inferior vena cava slightly deviated to the left. Robot-assisted laparoscopic excision of the retroperitoneal tumor was performed on October 15, 2010 with an operation time of 135 minutes and an estimated blood loss of less than 30 mL. The J-Vac drainage tube was removed on postoperative Day 3, and the patient was discharged in a stable condition the following day. The pathology of the tumor was retroperitoneal schwannoma. A re-evaluation was arranged postoperatively for the 15-month ambulatory visit. No local recurrence or distal metastasis was present.
在过去的几年中，机器人手术系统得到了快速发展。这些系统的进步和优势包括三维视觉和增强的人体工程学。这些优势帮助微创外科手术发展到了一个新的水平。达芬奇手术系统似乎极大地解决了传统腹腔镜手术治疗靠近大血管的腹膜后肿瘤时所面临的问题（例如，腹膜器官的广泛暴露和回缩）。关于腹腔镜切除下腔静脉、右肾血管和肾脏之间的腹膜后肿瘤的报道很少。我们报告了使用机器人手术系统进行这种治疗的情况。一名 54 岁女性患者在超声检查中偶然发现下腔静脉附近和右肾血管上方有一个低回声病变。CT 扫描显示右肾内侧约 4.4 厘米处有一个不均匀增强的腹膜后肿块，下腔静脉略向左侧偏移。2010 年 10 月 15 日，我们采用机器人辅助腹腔镜切除了该腹膜后肿瘤，手术时间为 135 分钟，估计出血量小于 30 毫升。术后第 3 天拔出 J-Vac 引流管，患者次日情况稳定出院。肿瘤的病理为腹膜后神经鞘瘤。术后 15 个月进行了门诊复查。未发现局部复发或远处转移。
