Vasudevan Vanitha, Reusche Ryan, Nelson Erek, Kaza Srinivas
Department of Surgery, University of Miami Miller School of Medicine Palm Beach Regional Campus, 5301 S congress Ave, Atlantis, FL, 33462, USA.
Department of Surgery, Mayo Clinic, 200 1st st SW, Rochester, MN, 55905, USA.
J Robot Surg. 2018 Mar;12(1):81-86. doi: 10.1007/s11701-017-0697-x. Epub 2017 Apr 3.
Robotic Surgery is becoming increasingly used in general surgery. The objective of this study is to evaluate the safety, effectiveness and short-term (less than 1 year) outcomes of Robotic Paraesophageal Hernia (RPEH) Surgery using the DaVinci Surgical Robot system (Intuitive Surgical, CA) in a large community hospital. This is a retrospective cohort study of 28 consecutive patients who underwent robotic paraesophageal hernia repair January 2011-March 2013 in this institution. Data and outcomes collected for analysis include patient demographics, operating times, conversion, complications, mortality and recurrence. The mean age of the patients was 68.7 +/- 12.7 years, 82% were females and the mean BMI was 29 +/- 6.3. The mean operative time, including the robot docking time, was 83.6 + 24 min. The average length of hospital stay (LOS) was 2.8 +/- 1.9 days. There were no conversions to open or laparoscopic procedures. Postoperative complications were noted in 3 patients (10.7%), including one mortality (3.4%). One symptomatic recurrence (3.4%) was noted during the 12-month follow-up period. Robotic Paraesophageal repair is a safe (similar rate of complication and mortality to literature for laparoscopic procedure) and an effective (paraeshopageal hernia repaired without high recurrence) procedure with acceptable complication rates even in older patients with high operative risks.
机器人手术在普通外科中的应用越来越广泛。本研究的目的是在一家大型社区医院中，评估使用达芬奇手术机器人系统（直观外科公司，加利福尼亚州）进行机器人经食管裂孔疝修补术（RPEH）的安全性、有效性和短期（少于1年）疗效。这是一项回顾性队列研究，研究对象为2011年1月至2013年3月在该机构接受机器人经食管裂孔疝修补术的28例连续患者。收集用于分析的数据和结果包括患者人口统计学资料、手术时间、中转情况、并发症、死亡率和复发情况。患者的平均年龄为68.7±12.7岁，82%为女性，平均体重指数为29±6.3。平均手术时间，包括机器人对接时间，为83.6±24分钟。平均住院时间（LOS）为2.8±1.9天。没有转为开放手术或腹腔镜手术的情况。3例患者（10.7%）出现术后并发症，包括1例死亡（3.4%）。在12个月的随访期内，发现1例有症状的复发（3.4%）。机器人经食管裂孔疝修补术是一种安全的手术（并发症和死亡率与腹腔镜手术的文献报道相似），也是一种有效的手术（经食管裂孔疝修补后复发率低），即使在手术风险高的老年患者中，并发症发生率也可接受。
