Mantoo Surendra, Rigaud Jerome, Naulet Sophie, Lehur Paul-Antoine, Meurette Guillaume
Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France.
J Robot Surg. 2014 Mar;8(1):7-12. doi: 10.1007/s11701-013-0411-6. Epub 2013 Jun 7.
Robotic-assisted surgery for pelvic floor disorders (PFD) meets the accepted standards for laparoscopic surgery. The aim of this study was to describe the technique and the impact of this standardized surgical technique and dedicated operating teams on the operative time for robotic-assisted laparoscopic ventral mesh rectopexy (RALVMR). Data from a prospective database were extracted for all patients who underwent RALVMR between January 2008 and May 2012 for multi-compartment PFD. Patient pre-, intra- and early postoperative data were analysed. To evaluate the impact of both the surgical technique and operating room team on operative time over successive years, we divided the total operation time (TOT) into robot set-up time (RST) and surgeon console time (SCT) including disembarking robotic arms and closure of wounds. A total of 51 patients (3 male) with a mean age of 61.1 [±11, standard deviation (SD)] years were included for analysis. There were no major complications or deaths. Median TOT fell significantly by 23 % from 2008 (270 min) to 2012 (179 min) (p < 0.0001). The largest reduction (>60 %) was seen in RST, from 55 (SD ±3) to 21 (SD ±2) min (p < 0.0001). Similarly, SCT was reduced by 36 % from 216 (SD ±12) to 138 (SD ±8) min (p < 0.0001). Decreased operative time and efficiency were facilitated by a devoted, well-trained and consistent team. A standardized surgical technique for PFD helps to reduce the duration of the surgical procedure.
机器人辅助手术治疗盆底功能障碍（PFD）符合腹腔镜手术的公认标准。本研究的目的是描述这种标准化手术技术及专业手术团队对机器人辅助腹腔镜腹侧补片直肠固定术（RALVMR）手术时间的影响。我们从一个前瞻性数据库中提取了2008年1月至2012年5月期间因多部位PFD接受RALVMR治疗的所有患者的数据。对患者术前、术中和术后早期的数据进行了分析。为了评估连续多年手术技术和手术室团队对手术时间的影响，我们将总手术时间（TOT）分为机器人设置时间（RST）和外科医生控制台操作时间（SCT），后者包括卸下机器人手臂和关闭伤口的时间。共有51例患者（3例男性）纳入分析，平均年龄为61.1[±11，标准差（SD）]岁。未发生重大并发症或死亡。TOT中位数从2008年的270分钟显著下降23%至2012年的179分钟（p<0.0001）。RST下降幅度最大（>60%），从55（SD±3）分钟降至21（SD±2）分钟（p<0.0001）。同样，SCT从216（SD±12）分钟减少36%至138（SD±8）分钟（p<0.0001）。一个专业、训练有素且稳定的团队有助于缩短手术时间并提高效率。PFD的标准化手术技术有助于缩短手术过程持续时间。
