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用于肥胖患者全子宫切除术的Senhance™手术机器人系统(“Senhance”):一项初步研究。

The Senhance™ surgical robotic system ("Senhance") for total hysterectomy in obese patients: a pilot study.

作者信息

Gueli Alletti Salvatore, Rossitto C, Cianci S, Perrone E, Pizzacalla S, Monterossi G, Vizzielli G, Gidaro S, Scambia G

机构信息

Department of Obstetrics and Gynecologic, "Policlinico Gemelli" Foundation, Catholic University of the Sacred Heart, L.go A. Gemelli, 1, 00168, Rome, Italy.

Biomedical and Experimental Sciences Department, "G. D'Annunzio" University, Chieti, Italy.

出版信息

J Robot Surg. 2018 Jun;12(2):229-234. doi: 10.1007/s11701-017-0718-9. Epub 2017 Jun 17.

Abstract

This pilot study was aimed to value the feasibility and safety of Senhance Robotic Platform for hysterectomy in obese patients. Ten obese patients (30 < BMI < 40) underwent elective Senhance total extrafascial hysterectomy with bilateral salpingo-oophorectomy at the Division of Gynecologic Oncology of "Policlinico A. Gemelli" Foundation, Rome, Italy. Perioperative and postoperative outcomes data were recorded. The median age was 60 years (range 51-75) and the median BMI was 33.3 kg/m (range 30.4-38.3). The median uterine weight was 112.5 g (range 77-225). Indication to total hysterectomy was early-stage (FIGO Stage IA) endometrial cancer in 100% of patients. The median operative time (OT) was 110 min (70-200). The median docking time was 10.5 min (5-25). The median estimated blood loss was 100 mL (50-200). No conversions to laparotomy were recorded. No intra- and 30-day postoperative complications were registered. The median ileus was 17 h (12-36) and the median time to discharge was 2 days (1-4). The median VAS scores registered at 2, 4, 12, and 24 h were, respectively, 2 (1-3), 2 (1-3), 4 (1-8), and 3 (1-5). Our study results suggest that Senhance platform could be safe for hysterectomy even in obese patients. More clinical data are needed to determine whether this approach would offer any additional benefits in a new middle line between standard laparoscopy and robotics.

摘要

本前瞻性研究旨在评估森海思机器人平台用于肥胖患者子宫切除术的可行性和安全性。10例肥胖患者(BMI为30<BMI<40)在意大利罗马“波利克利尼科A.杰梅利”基金会妇科肿瘤学部接受了选择性森海思全筋膜外子宫切除术及双侧输卵管卵巢切除术。记录围手术期和术后结果数据。中位年龄为60岁(范围51 - 75岁),中位BMI为33.3kg/m²(范围30.4 - 38.3)。中位子宫重量为112.5g(范围77 - 225g)。所有患者全子宫切除术的指征均为早期(FIGO IA期)子宫内膜癌。中位手术时间(OT)为110分钟(70 - 200分钟)。中位对接时间为10.5分钟(5 - 25分钟)。中位估计失血量为100mL(50 - 200mL)。未记录到中转开腹情况。未发生术中及术后30天内并发症。中位肠梗阻时间为17小时(12 - 36小时),中位出院时间为2天(1 - 4天)。术后2、4、12和24小时记录的中位VAS评分分别为2(1 - 3)、2(1 - 3)、4(1 - 8)和3(1 - 5)。我们的研究结果表明,即使对于肥胖患者,森海思平台用于子宫切除术可能也是安全的。需要更多临床数据来确定这种方法在标准腹腔镜手术和机器人手术之间的新中间路线上是否会带来任何额外益处。

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