Maurice Matthew J, Kaouk Jihad H
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
BJU Int. 2017 Dec;120(6):881-884. doi: 10.1111/bju.13947. Epub 2017 Aug 8.
To assess the feasibility of radical perineal cystoprostatectomy using the latest generation purpose-built single-port robotic surgical system.
In two male cadavers the da Vinci SP1098 Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) was used to perform radical perineal cystoprostatectomy and bilateral extended pelvic lymph node dissection (ePLND). New features in this model include enhanced high-definition three-dimensional optics, improved instrument manoeuvrability, and a real-time instrument tracking and guidance system. The surgery was accomplished through a 3-cm perineal incision via a novel robotic single-port system, which accommodates three double-jointed articulating robotic instruments, an articulating camera, and an accessory laparoscopic instrument. The primary outcomes were technical feasibility, intraoperative complications, and total robotic operative time.
The cases were completed successfully without conversion. There were no accidental punctures or lacerations. The robotic operative times were 197 and 202 min.
In this preclinical model, robotic radical perineal cystoprostatectomy and ePLND was feasible using the SP1098 robotic platform. Further investigation is needed to assess the feasibility of urinary diversion using this novel approach and new technology.
评估使用最新一代专用单孔机器人手术系统进行根治性会阴膀胱前列腺切除术的可行性。
在两具男性尸体上，使用达芬奇SP1098手术系统（直观外科公司，美国加利福尼亚州桑尼维尔）进行根治性会阴膀胱前列腺切除术和双侧扩大盆腔淋巴结清扫术（ePLND）。该模型的新特性包括增强的高清三维光学系统、改进的器械可操作性以及实时器械跟踪和引导系统。手术通过一个3厘米的会阴切口，经一种新型机器人单孔系统完成，该系统可容纳三个双关节铰接式机器人器械、一个铰接式摄像头和一个辅助腹腔镜器械。主要结果为技术可行性、术中并发症和机器人手术总时间。
病例均成功完成，无需中转。无意外穿刺或撕裂伤。机器人手术时间分别为197分钟和202分钟。
在这个临床前模型中，使用SP1098机器人平台进行机器人根治性会阴膀胱前列腺切除术和ePLND是可行的。需要进一步研究以评估使用这种新方法和新技术进行尿流改道的可行性。
