体重小于10公斤患儿的机器人肾盂成形术：初步经验
Pediatric robotic pyeloplasty in patients weighing less than 10 kg initial experience.
作者信息
Pelizzo Gloria, Nakib Ghassan, Goruppi Ilaria, Avolio Luigi, Romano Piero, Raffaele Alessandro, Scorletti Federico, Mencherini Simonetta, Calcaterra Valeria
机构信息
Departments of *Pediatric Surgery †Anaesthesiology and Intensive Care ‡Pediatrics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
出版信息
Surg Laparosc Endosc Percutan Tech. 2014 Feb;24(1):e29-31. doi: 10.1097/SLE.0b013e31828e3f18.
AIM
To report the feasibility and safety of a robotic-assisted laparoscopic pyeloplasty (RALP) in patients weighing <10 kg.
MATERIALS AND METHODS
Three patients weighing between 5 and 8 kg who were affected by severe congenital ureteropelvic junction obstruction, including a child with solitary kidney, were subjected to RALP. Three trocars were placed; sutures and pyeloplasty remodeling were performed with interrupted stitches. A double J stent was inserted through a 2-mm transparietal angiocatheter to protect the pyelic suture.
RESULTS
The procedures were all completed within 90 minutes, the "docking" time requiring 20 minutes. The patients were discharged on postoperative day 2, without any complications.
CONCLUSIONS
Comprehensive assessment of pyelic suture in a very narrow field with 2 operative instruments is feasible and safe. Robotic pyeloplasty provides all the advantages of mini-invasive surgery with the added advantage of higher magnification and excellent surgical navigation in very small spaces and on fragile infant tissues.
目的
报告机器人辅助腹腔镜肾盂成形术（RALP）应用于体重<10 kg患者的可行性和安全性。
材料与方法
对3例体重在5至8 kg之间、患有严重先天性肾盂输尿管连接处梗阻的患者（包括1例单肾患儿）实施RALP。置入3个套管针；采用间断缝合进行缝合及肾盂成形术重塑。通过一根2毫米的经皮血管导管插入双J支架以保护肾盂缝线。
结果
手术均在90分钟内完成，“对接”时间需要20分钟。患者术后第2天出院，无任何并发症。
结论
使用2个手术器械在非常狭窄的视野中对肾盂缝线进行全面评估是可行且安全的。机器人肾盂成形术具备微创手术的所有优点，还具有更高放大倍数以及在极小空间和脆弱婴儿组织上出色的手术导航等额外优势。
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