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韩国一家机构使用达芬奇机器人手术系统进行机器人手术的疗效与安全性:10000例经验

Efficacy and Safety of Robotic Procedures Performed Using the da Vinci Robotic Surgical System at a Single Institute in Korea: Experience with 10000 Cases.

作者信息

Koh Dong Hoon, Jang Won Sik, Park Jae Won, Ham Won Sik, Han Woong Kyu, Rha Koon Ho, Choi Young Deuk

机构信息

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

出版信息

Yonsei Med J. 2018 Oct;59(8):975-981. doi: 10.3349/ymj.2018.59.8.975.

Abstract

PURPOSE

To evaluate the efficacy and safety of robotic procedures performed using the da Vinci Robotic Surgical System at a single institute.

MATERIALS AND METHODS

We analyzed all robotic procedures performed at Severance Hospital, Yonsei University Health System (Seoul, Korea). Reliability and mortality rates of the robotic surgeries were also investigated.

RESULTS

From July 2005 to December 2013, 10267 da Vinci robotic procedures were performed in seven different departments by 47 surgeons at our institute. There were 5641 cases (54.9%) of general surgery, including endocrine (38.0%), upper (7.7%) and lower gastrointestinal tract (7.5%), hepato-biliary and pancreatic (1.2%), and pediatric (0.6%) surgeries. Urologic surgery (33.0%) was the second most common, followed by otorhinolaryngologic (7.0%), obstetric and gynecologic (3.2%), thoracic (1.5%), cardiac (0.3%), and neurosurgery (0.1%). Thyroid (40.8%) and prostate (27.4%) procedures accounted for more than half of all surgeries, followed by stomach (7.6%), colorectal (7.5%), kidney and ureter (5.1%), head and neck (4.0%), uterus (3.2%), thoracic (1.5%), and other (2.9%) surgeries. Most surgeries (94.5%) were performed for malignancies. General and urologic surgeries rapidly increased after 2005, whereas others increased slowly. Thyroid and prostate surgeries increased rapidly after 2007. Surgeries for benign conditions accounted for a small portion of all procedures, although the numbers thereof have been steadily increasing. System malfunctions and failures were reported in 185 (1.8%) cases. Mortality related to robotic surgery was observed for 12 (0.12%) cases.

CONCLUSION

Robotic surgeries have increased steadily at our institution. The da Vinci Robotic Surgical System is effective and safe for use during surgery.

摘要

目的

评估在单一机构使用达芬奇机器人手术系统进行机器人手术的疗效和安全性。

材料与方法

我们分析了延世大学医疗系统Severance医院(韩国首尔)进行的所有机器人手术。还调查了机器人手术的可靠性和死亡率。

结果

2005年7月至2013年12月,我院47名外科医生在7个不同科室进行了10267例达芬奇机器人手术。普外科手术有5641例(54.9%),包括内分泌手术(38.0%)、上消化道手术(7.7%)、下消化道手术(7.5%)、肝胆胰手术(1.2%)和小儿外科手术(0.6%)。泌尿外科手术(33.0%)是第二常见的,其次是耳鼻咽喉科手术(7.0%)、妇产科手术(3.2%)、胸科手术(1.5%)、心脏手术(0.3%)和神经外科手术(0.1%)。甲状腺手术(40.8%)和前列腺手术(27.4%)占所有手术的一半以上,其次是胃部手术(7.6%)、结直肠手术(7.5%)、肾脏和输尿管手术(5.1%)、头颈手术(4.0%)、子宫手术(3.2%)、胸科手术(1.5%)和其他手术(2.9%)。大多数手术(94.5%)是针对恶性肿瘤进行的。2005年后,普外科和泌尿外科手术迅速增加,而其他科室手术增加缓慢。2007年后,甲状腺和前列腺手术迅速增加。良性疾病手术占所有手术的比例较小,但其数量一直在稳步增加。报告了185例(1.8%)系统故障。观察到12例(0.12%)与机器人手术相关的死亡病例。

结论

我院机器人手术稳步增加。达芬奇机器人手术系统在手术中使用是有效且安全的。

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