Department of Urology, Temple University School of Medicine, Philadelphia, PA.
Department of Urology, Temple University School of Medicine, Philadelphia, PA.
Am J Obstet Gynecol. 2016 May;214(5):566-71. doi: 10.1016/j.ajog.2015.10.150. Epub 2015 Oct 28.
Iatrogenic ureteral injuries, more than half of which occur during gynecologic surgery, may have devastating consequences for both patients and physicians. Gynecologists have employed various techniques such as cystoscopy, ureteral stents, and lighted ureteral stents to prevent ureteral injuries. The emergence and increasing prevalence of robotic surgery necessitates that we not only reevaluate the utility of these techniques, but also develop new ones specific for the robotic modality. In the robotic setting, the surgeon lacks tactile feedback and must rely primarily on visual cues. The use of intraureteral indocyanine green and subsequent visualization under near-infrared fluorescence appears to be a promising technique to primarily and secondarily prevent ureteral injuries during robotic gynecologic surgery.
医源性输尿管损伤，其中一半以上发生在妇科手术过程中，可能对患者和医生都造成灾难性的后果。妇科医生采用了各种技术，如膀胱镜检查、输尿管支架和导光输尿管支架，以防止输尿管损伤。机器人手术的出现和日益普及，不仅需要我们重新评估这些技术的实用性，还需要开发专门针对机器人模式的新技术。在机器人环境中，外科医生缺乏触觉反馈，只能主要依赖视觉线索。在机器人妇科手术中，使用腔内吲哚菁绿并在近红外荧光下进行可视化，似乎是一种很有前途的技术，可以主要和次要地预防输尿管损伤。
