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单部位机器人胆囊切除术:进展时间表。

Single-Site Robotic Cholecystectomy: The Timeline of Progress.

作者信息

Bibi Shahida, Rahnemai-Azar Amir A, Coralic Jasna, Bayoumi Mohamed, Khorsand Joubin, Farkas Daniel T, Prasad Leela M

机构信息

Center for Robotic Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, 60068, USA,

出版信息

World J Surg. 2015 Oct;39(10):2386-91. doi: 10.1007/s00268-015-3135-0.

Abstract

AIM

To investigate the learning curve and perioperative outcomes of single-site robotic cholecystectomy during the first 102 cases by a single surgeon.

MATERIALS AND METHODS

A retrospective review of a prospectively maintained database was performed on the first 102 cases of single-site robotic cholecystectomy. Patients were divided into five chronological groups based on the date of surgery, with 20 patients in each group except the 5th group which had 22 patients. The groups were compared by docking time, robotic dissection time, and overall surgery time. A P value of 0.05 was used as statistically significant.

RESULTS

The female to male ratio was 2:1. The mean age was 51 years (18-87) and the mean BMI was 28.26 (18-41). Overall, 69 % of the patients underwent elective cholecystectomy and 31 % required urgent surgery. In all, 17 % of patients had previous abdominal surgeries. In total, 45 % of procedures were regarded as same day surgery. The total mean length of stay was 1.97 days (0-8). The mean operative time was 110 min (36-265), mean robotic console time 70 min (26-179), and mean docking time 9 min (1-26). The overall conversion rate was 3.9 % and the complication rate was 4 %. The docking time, robotic time, and average operative time were significantly different in the first group as compared to the remaining the five groups (P = 0.001).

CONCLUSION

Single-site robotic cholecystectomy is safe in both elective and urgent conditions, and in patients with previous abdominal surgeries. It has a short learning curve.

摘要

目的

探讨由一名外科医生完成的前102例单孔机器人胆囊切除术的学习曲线和围手术期结果。

材料与方法

对前瞻性维护的数据库进行回顾性分析,纳入前102例单孔机器人胆囊切除术病例。根据手术日期将患者分为五个按时间顺序排列的组,每组20例,第5组22例。比较各组的对接时间、机器人手术时间和总手术时间。P值<0.05具有统计学意义。

结果

男女比例为2:1。平均年龄51岁(18 - 87岁),平均体重指数28.26(18 - 41)。总体而言,69%的患者接受择期胆囊切除术,31%需要急诊手术。17%的患者既往有腹部手术史。45%的手术被视为当日手术。总平均住院时间为1.97天(0 - 8天)。平均手术时间为110分钟(36 - 265分钟),平均机器人控制台操作时间70分钟(26 - 179分钟),平均对接时间9分钟(1 - 26分钟)。总体中转率为3.9%,并发症发生率为4%。与其余五组相比,第一组的对接时间、机器人手术时间和平均手术时间有显著差异(P = 0.001)。

结论

单孔机器人胆囊切除术在择期和急诊情况下以及有腹部手术史的患者中均安全,且学习曲线短。

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