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大学医院小儿机器人手术的麻醉体验。

Anesthesia experience of pediatric robotic surgery in a University Hospital.

机构信息

Department of Anesthesia, College of Medicine, King Saud University, P.O. Box 2925, Riyadh, 11461, Saudi Arabia.

出版信息

J Robot Surg. 2019 Feb;13(1):141-146. doi: 10.1007/s11701-018-0834-1. Epub 2018 Jun 13.

Abstract

Robotic technology has a promising future in surgical field. Robotic-assisted laparoscopy is a newly advance technology which is highly accepted by most of surgeons in various surgical procedures. As the pediatric surgeons adopt and master robotic technique, anesthesiologists familiarized themselves with this technique as well. Robotic surgery required a high-quality of perioperative anesthesia care that is essential for optimizing surgical outcome and patient safety. A retrospective analysis of robotic-assisted surgery for all children under age of 18 years from June 2004 to November 2013 at King Khalid University Hospital was conducted. Data of demographic (age, sex, and weight), type of procedures, operative time, intraoperative and postoperative complications were noted. Seventy robot assisted laparoscopy procedures were performed using the da Vinci surgical system. All procedures except three cases were successfully completed using robot with mean operative time of 110 min. Nissen fundoplication (34 cases) was the commonest robotic surgical procedure performed followed by cholecystectomy, anal-pull through and gastric banding. There were no intraoperative and postoperative complications related to anesthesia. Robotic-assisted laparoscopy is a safe and feasible technique for a variety of pediatric procedures. Our findings suggest that, perioperative anesthesia care should be considered in advance with high anesthetic precautions to maximize patient safety and improve surgical outcome. It is worth to have more studies measuring clinical anesthesia outcome of pediatric robotic surgery.

摘要

机器人技术在外科领域有广阔的前景。机器人辅助腹腔镜手术是一种新的先进技术,在各种外科手术中得到了大多数外科医生的高度认可。随着小儿外科医生采用并掌握了机器人技术,麻醉师也对这项技术有所了解。机器人手术需要高质量的围手术期麻醉护理,这对于优化手术结果和患者安全至关重要。对 2004 年 6 月至 2013 年 11 月在哈立德国王大学医院接受机器人辅助手术的所有 18 岁以下儿童进行了回顾性分析。记录了人口统计学数据(年龄、性别和体重)、手术类型、手术时间、术中及术后并发症。使用达芬奇手术系统完成了 70 例机器人辅助腹腔镜手术。除 3 例外,所有手术均成功完成,机器人平均手术时间为 110 分钟。Nissen 胃底折叠术(34 例)是最常见的机器人手术,其次是胆囊切除术、肛门直肠提拉术和胃束带术。麻醉相关的术中及术后并发症均无发生。机器人辅助腹腔镜手术是一种安全可行的小儿多种手术技术。我们的研究结果表明,应提前考虑围手术期麻醉护理,并采取高度的麻醉预防措施,以最大限度地提高患者安全并改善手术结果。值得进行更多研究来衡量小儿机器人手术的临床麻醉结果。

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