Menderes Gulden, Clark Lindsay, Azodi Masoud
Yale New Haven Health, Bridgeport Hospital, 267 Grant St, Bridgeport, CT, 06610, USA.
Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
J Robot Surg. 2014 Sep;8(3):195-200. doi: 10.1007/s11701-014-0462-3. Epub 2014 Apr 30.
We report a robotic-assisted, ultrasound-guided abdominal cerclage placement during pregnancy that resulted in term delivery, and review the current literature with respect to the efficacy of robotic-assisted transabdominal cerclage (RoboTAC) placement. The patient was a 25-year-old gravida 5 para 0-0-4-0 with cervical insufficiency who failed McDonald cerclage placement in two prior pregnancies, and presented at 13 weeks with a shortened (1.66 cm) cervical length. Placement of abdominal cerclage with robotic assistance under ultrasound guidance was performed at a teaching hospital. The main outcome measure was feasibility of RoboTAC placement in a gravid uterus under ultrasound guidance, and delivery of an infant ≥34 weeks of gestation with neonatal survival. Abdominal cerclage was safely and successfully placed at 13 weeks with robotic assistance. The patient had an otherwise uncomplicated antenatal course and was delivered via primary cesarean section at 38 weeks. Robotic-assisted abdominal cerclage can be considered for patients who require abdominal cerclage placement by skilled robotic surgeons.
我们报告了一例在孕期通过机器人辅助、超声引导下进行的腹部宫颈环扎术，该手术成功实现足月分娩，并回顾了目前关于机器人辅助经腹宫颈环扎术（RoboTAC）有效性的文献。患者为一名25岁、孕5产0 - 0 - 4 - 0的女性，有宫颈机能不全病史，前两次妊娠时McDonald宫颈环扎术失败，孕13周时宫颈长度缩短至1.66厘米。在一家教学医院，于超声引导下通过机器人辅助进行了腹部宫颈环扎术。主要观察指标是在超声引导下在妊娠子宫内进行RoboTAC手术的可行性，以及分娩孕周≥34周且新生儿存活。在机器人辅助下，于孕13周时安全、成功地进行了腹部宫颈环扎术。患者产前过程无其他并发症，于孕38周行首次剖宫产分娩。对于需要由熟练的机器人外科医生进行腹部宫颈环扎术的患者，可考虑采用机器人辅助腹部宫颈环扎术。
