Panteleimonitis Sofoklis, Harper Mick, Hall Stuart, Figueiredo Nuno, Qureshi Tahseen, Parvaiz Amjad
School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, PO1 2FR, UK.
Poole Hospital NHS Trust, Longfleet Road, Poole, BH15 2JB, UK.
J Robot Surg. 2018 Sep;12(3):433-436. doi: 10.1007/s11701-017-0752-7. Epub 2017 Sep 15.
Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion. A stepwise approach of the da Vinci docking process and surgical technique is described accompanied by an intra-operative video that demonstrates this technique. We also present data collected from a prospectively maintained database. 33 consecutive rectal cancer patients (24 male, 9 female) received robotic rectal surgery with the da Vinci Xi during the preparation of this technical note. 29 (88%) patients had anterior resections, and four (12%) had abdominoperineal excisions. There were no conversions, no anastomotic leaks and no mortality. Median operation time was 331 (249-372) min, blood loss 20 (20-45) mls and length of stay 6.5 (4-8) days. 30-day readmission rate and re-operation rates were 3% (n = 1). This standardised technique of single docking robotic rectal surgery with the da Vinci Xi is safe, feasible and reproducible. The technological advances of the new robotic system facilitate the totally robotic single docking approach.
机器人直肠手术在结直肠外科医生中越来越受欢迎。然而，手术过程中在机器人平台对接、机械臂碰撞以及平台脱离等方面所花费的时间，是外科医生常觉得麻烦且耗时的因素。最新的手术平台——达芬奇Xi系统，结合手术台的集成移动功能，有助于克服这些问题。本技术说明旨在描述一种使用达芬奇Xi系统和手术台集成移动功能的单对接机器人直肠手术的标准化手术技术。文中描述了达芬奇对接过程和手术技术的逐步方法，并配有展示该技术的术中视频。我们还展示了从一个前瞻性维护的数据库中收集的数据。在撰写本技术说明期间，33例连续的直肠癌患者（24例男性，9例女性）接受了达芬奇Xi机器人直肠手术。29例（88%）患者进行了前切除术，4例（12%）进行了腹会阴联合切除术。无中转开腹、无吻合口漏且无死亡病例。中位手术时间为331（249 - 372）分钟，失血量为20（20 - 45）毫升，住院时间为6.5（4 - 8）天。30天再入院率和再次手术率均为3%（n = 1）。这种使用达芬奇Xi系统的单对接机器人直肠手术标准化技术是安全、可行且可重复的。新机器人系统的技术进步推动了完全机器人单对接手术方法的发展。
