Zil-E-Ali Ahsan, Assad Salman, Jabbar Furrukh
General Surgery, Pak Red Crescent Hospital.
Department of Medicine, Shifa International Hospital, Islamabad, Pakistan.
Cureus. 2017 Jun 3;9(6):e1306. doi: 10.7759/cureus.1306.
Operating on more than a single procedure in a same surgical intervention saves time, anesthesia duration and can increase the overall quality of life by lowering the duration of hospital stay and minimizing patient anxiety. But such interventions require expertise, high surgical performance, and precision in anatomical manipulation. We present a case of an outstanding performance of a unique minimally invasive simultaneous approach of removing a pre-pyloric gastrointestinal stromal tumor (GIST) along with a cholecystectomy by a robot-assisted laparascopic surgical system. So far, only 33 cases of GIST have been reported in literature that were managed by robot-assistance, and this case is the first of its kind. This is the case of a 60-year-old overweight female who presented for a follow-up for chest discomfort, shortness of breath, chronic gastric reflux and classical features of cholecystitis along with diarrheal and constipation episodes. A gastroduodenoscopy showed a mass in the pre-pyloric area that extended in the luminal cavity. A robot-assisted laparascopic approach was planned, and with precision and surgical expertise the mass was removed along with a cholecystectomy. The surgical specimen were confirmed on histopathology.
在同一台外科手术中进行多个手术操作可节省时间、缩短麻醉时长，还能通过缩短住院时间和减少患者焦虑来提高整体生活质量。但此类手术需要专业技能、高超的手术水平以及精确的解剖操作。我们展示了一个独特的案例，即通过机器人辅助腹腔镜手术系统，以微创同步方式成功切除幽门前胃肠道间质瘤（GIST）并进行胆囊切除术，手术表现卓越。到目前为止，文献中仅报道了33例由机器人辅助治疗的GIST病例，而本病例尚属首例。这是一名60岁超重女性，因胸部不适、呼吸急促、慢性胃反流以及胆囊炎的典型症状，伴有腹泻和便秘发作前来复诊。胃镜检查显示幽门前区有一个向管腔内延伸的肿块。计划采用机器人辅助腹腔镜手术方法，凭借精准操作和手术专业技能，成功切除肿块并进行了胆囊切除术。手术标本经组织病理学确诊。
