Gungor Mete, Kahraman Korhan, Dursun Polat, Ozbasli Esra, Genim Canan
Department of Obstetrics and Gynecology, Acibadem University School of Medicine, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Koru Ankara Hospital, Ankara, Turkey.
J Robot Surg. 2018 Mar;12(1):87-92. doi: 10.1007/s11701-017-0699-8. Epub 2017 Apr 20.
This study evaluated the feasibility and safety of robotic single port hysterectomy and laparoscopic single port hysterectomy, and to compare the perioperative parameters of the two systems. Twenty patients underwent robotic single port hysterectomy and 25 patients underwent laparoscopic single port hysterectomy. All hysterectomies were successfully performed via a single port and there were no conversions to conventional multi-port laparoscopy, multi-port robotic, open surgery, or vaginal surgery. The median operative time and hysterectomy time in robotic and laparoscopic groups were 90 vs. 90 min (P 0.74), 57.5 vs. 60 min (P 0.17), respectively. The median estimated blood loss was 40 ml in the robotic group and 50 ml in the laparoscopic group (P 0.77). No operative and post-operative complications were observed in the two groups. The median time to discharge from the hospital was one day for both techniques (P 0.17). Robotic and laparoscopic single port systems are feasible and safe for hysterectomy operation in terms of operative time, conversion to laparotomy or multiport laparoscopy/robotic rates, complication rates, and postoperative results in the hands of experienced surgeons. The possible benefits of robotic single port surgery compared with conventional laparoscopy should be evaluated in further randomized controlled studies.
本研究评估了机器人单孔子宫切除术和腹腔镜单孔子宫切除术的可行性和安全性，并比较了两种手术系统的围手术期参数。20例患者接受了机器人单孔子宫切除术，25例患者接受了腹腔镜单孔子宫切除术。所有子宫切除术均通过单孔成功完成，未转为传统多孔腹腔镜手术、多孔机器人手术、开放手术或阴道手术。机器人组和腹腔镜组的中位手术时间和子宫切除时间分别为90分钟对90分钟（P = 0.74）、57.5分钟对60分钟（P = 0.17）。机器人组的中位估计失血量为40毫升，腹腔镜组为50毫升（P = 0.77）。两组均未观察到手术中和术后并发症。两种技术的中位出院时间均为1天（P = 0.17）。对于经验丰富的外科医生而言，机器人和腹腔镜单孔系统在子宫切除手术的手术时间、转为开腹手术或多孔腹腔镜手术/机器人手术的比例、并发症发生率及术后结果方面是可行且安全的。与传统腹腔镜手术相比，机器人单孔手术的潜在优势应在进一步的随机对照研究中进行评估。
