Lo Ing-Shiang, Lee Hsiang-Ying, Chou Yii-Her, Huang Chun-Nung, Wu Wen-Jeng, Yeh Hsin-Chih, Yang Kai Fu, Lee Cheng Hsueh, Li Ching-Chia
1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung, Taiwan .
2 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital , Kaohsiung, Taiwan .
J Laparoendosc Adv Surg Tech A. 2018 Feb;28(2):140-144. doi: 10.1089/lap.2017.0421. Epub 2017 Nov 1.
To demonstrate a feasible procedure of robot-assisted extraperitoneal radical prostatectomy single site plus two model to overcome the limitation of traditional single-port laparoscopic surgery.
All consecutive cases of robot-assisted extraperitoneal radical prostatectomy single site plus two model between November 2015 and April 2016 in our institution were included. We analyze the surgical and continence outcome.
Twenty cases were included in the analysis. All cases successfully completed without any necessity for conversion to a standard laparoscopic approach or open surgery. The average age is 64.3 ± 8.2 years and average body mass index is 24.3 ± 2.9 kg/m. Eight focal positive margins (40%) (5 in T2 and 3 in T3a disease) were encountered and all occurred at the apex. For continence outcomes, 9 (45%) patients need average 0-1 pads/day and 2 (10%) patients need average 3 pads/day after surgery, but most recover after several months. No intraoperative complications or major postoperative complications were recorded, excluding blood transfusion in one case.
Robot-assisted extraperitoneal radical prostatectomy single site plus two model is technically feasible and safe in our experience. It can also be performed in patients that have previously received intraperitoneal abdominal surgery using the extraperitoneal approach. We can take this procedure into account for minimal invasive surgical option.
展示一种机器人辅助腹膜外根治性前列腺切除术单点加双模式的可行手术方法，以克服传统单孔腹腔镜手术的局限性。
纳入2015年11月至2016年4月在本机构接受机器人辅助腹膜外根治性前列腺切除术单点加双模式的所有连续病例。我们分析手术和控尿结果。
20例纳入分析。所有病例均成功完成，无需转换为标准腹腔镜手术或开放手术。平均年龄为64.3±8.2岁，平均体重指数为24.3±2.9kg/m²。发现8个切缘阳性（40%）（T2期5个，T3a期3个），均发生在尖部。关于控尿结果，9例（45%）患者术后平均每天需要0至1片尿垫，2例（10%）患者术后平均每天需要3片尿垫，但大多数患者在数月后恢复。除1例输血外，未记录术中并发症或重大术后并发症。
根据我们的经验，机器人辅助腹膜外根治性前列腺切除术单点加双模式在技术上是可行且安全的。对于既往接受过腹腔内腹部手术的患者，也可采用腹膜外入路进行该手术。我们可以将此手术作为微创外科手术选择加以考虑。
