Sendag Fatih, Akdemir Ali, Zeybek Burak, Ozdemir Asuman, Gunusen Ilkben, Oztekin Mehmet Kemal
Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):689-94. doi: 10.1016/j.jmig.2014.02.006. Epub 2014 Feb 13.
To evaluate the safety and feasibility of robotic single-site total hysterectomy and to compare the outcomes of newly implemented robotic single-site bipolar and external vessel-sealing device.
Retrospective study (Canadian Task Force classification II-1).
University hospital.
Twenty-four patients with benign indications for hysterectomy.
All patients underwent robotic-assisted single-incision transumbilical total hysterectomy using the novel da Vinci Single-Site Platform. Vaginal cuff closures were performed intracorporeally using the same technique in all cases.
The median age of the patients was 49.5 years (range, 40-61), and body mass index was 28.5 (range, 21-34). Blood loss was 22.5 mL (range, 7-120 mL). Docking time was 5.5 minutes (range, 3-10 minutes), console time was 74.5 minutes (range, 60-160 minutes), vaginal cuff closure time was 25 minutes (range, 16-41 minutes), and total operative time was 98.5 minutes (range, 71-183 minutes). When 2 groups were created according to the energy devices used during the procedures, console time in the newly implemented bipolar group was shorter than in the external sealing device group (69.5 minutes vs. 77 minutes; p = .03); however, no differences were found for uterus removal time (50.5 minutes vs. 53.5 minutes; p = .13). Differences were observed in vaginal cuff closure time (18.5 minutes vs 23 minutes; p = .01).
Robotic single-site total hysterectomy using a newly implemented bipolar grasping instrument and even with intracorporeal cuff closure is a safe and feasible procedure in appropriately selected patients.
评估机器人单孔全子宫切除术的安全性和可行性，并比较新实施的机器人单孔双极和外部血管封闭装置的手术效果。
回顾性研究（加拿大工作组分类II-1）。
大学医院。
24例有子宫切除良性指征的患者。
所有患者均使用新型达芬奇单孔平台接受机器人辅助单切口经脐全子宫切除术。所有病例均采用相同技术在体内进行阴道残端闭合。
患者的中位年龄为49.5岁（范围40-61岁），体重指数为28.5（范围21-34）。出血量为22.5毫升（范围7-120毫升）。对接时间为5.5分钟（范围3-10分钟），控制台操作时间为74.5分钟（范围60-160分钟），阴道残端闭合时间为25分钟（范围16-41分钟），总手术时间为98.5分钟（范围71-183分钟）。根据手术过程中使用的能量装置将患者分为两组，新实施的双极组的控制台操作时间短于外部封闭装置组（69.5分钟对77分钟；p = 0.03）；然而，子宫切除时间无差异（50.5分钟对53.5分钟；p = 0.13）。阴道残端闭合时间存在差异（18.5分钟对23分钟；p = 0.01）。
对于经过适当选择的患者，使用新实施的双极抓持器械并在体内进行残端闭合的机器人单孔全子宫切除术是一种安全可行的手术。
