Grade Marian, Beham Alexander W, Schüler P, Kneist Werner, Ghadimi B Michael
Department of General, Visceral and Pediatric Surgery, University Medical Center, Robert-Koch-Str. 40, 37075, Goettingen, Germany.
Department of General, Visceral and Transplant Surgery, University Medical Center, Langenbeckstraße 1, 55131, Mainz, Germany.
J Robot Surg. 2016 Jun;10(2):157-60. doi: 10.1007/s11701-015-0556-6. Epub 2015 Dec 24.
While the oncological outcome of patients with rectal cancer has been considerably improved within the last decades, anorectal, urinary and sexual functions remained impaired at high levels, regardless of whether radical surgery was performed open or laparoscopically. Consequently, intraoperative monitoring of the autonomic pelvic nerves with simultaneous electromyography of the internal anal sphincter and manometry of the urinary bladder has been introduced to advance nerve-sparing surgery and to improve functional outcome. Initial results suggested that pelvic neuromonitoring may result in better functional outcomes. Very recently, it has also been demonstrated that minimally invasive neuromonitoring is technically feasible. Because, to the best of our knowledge, pelvic neuromonitoring has not been performed during robotic surgery, we report the first case of robotic-assisted low anterior rectal resection combined with intraoperative monitoring of the autonomic pelvic nerves.
尽管在过去几十年中直肠癌患者的肿瘤学治疗结果有了显著改善，但无论根治性手术是采用开放手术还是腹腔镜手术，肛门直肠、泌尿和性功能仍有很高比例的受损。因此，术中对自主盆腔神经进行监测，同时对内括约肌进行肌电图检查和对膀胱进行测压，已被引入以推进保留神经的手术并改善功能结果。初步结果表明，盆腔神经监测可能会带来更好的功能结果。最近，也已证明微创神经监测在技术上是可行的。据我们所知，由于在机器人手术期间尚未进行盆腔神经监测，我们报告了首例机器人辅助低位前直肠切除术联合术中自主盆腔神经监测的病例。
