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使用SP手术系统的纯单部位机器人辅助部分肾切除术:初步临床经验

Pure Single-Site Robot-Assisted Partial Nephrectomy Using the SP Surgical System: Initial Clinical Experience.

作者信息

Kaouk Jihad, Garisto Juan, Eltemamy Mohamed, Bertolo Riccardo

机构信息

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.

出版信息

Urology. 2019 Feb;124:282-285. doi: 10.1016/j.urology.2018.11.024. Epub 2018 Nov 23.

Abstract

OBJECTIVES

To describe the technique of pure single-site trans-peritoneal robotic partial nephrectomy using the da Vinci SP surgical system.

METHODS

Three consecutive patients who were diagnosed with contrast-enhanced renal masses amenable of partial nephrectomy were scheduled for robot-assisted partial nephrectomy to be performed using the SP Surgical System. Data collection received Institutional Review Board Approval (IRB 13-780). Subjects were provided with informed consent explaining the adoption of the novel surgical platform. The procedures were performed by reproducing the steps of the standard institutional multiarms robotic approach to partial nephrectomy.

RESULTS

The surgeries were successfully performed. There was no need for conversion to standard multiports robotic approach nor need for additional ports placement. All the procedures were completed according to a pure single-site approach. No intraoperative complications occurred. The total robotic operative time averaged 180 minutes. The warm ischemia time averaged 25 minutes. Blood loss averaged 180 mL. One patient had postoperative acute bleeding and underwent angioembolization. All patients had negative surgical margins.

CONCLUSION

The feasibility of pure single-site transperitoneal robot-assisted partial nephrectomy using the novel SP surgical system is demonstrated. Further studies are needed to confirm the results reported herein.

摘要

目的

描述使用达芬奇SP手术系统进行单纯单部位经腹膜机器人辅助部分肾切除术的技术。

方法

连续3例被诊断为适合行部分肾切除术的增强型肾肿块患者计划使用SP手术系统进行机器人辅助部分肾切除术。数据收集获得了机构审查委员会的批准(IRB 13 - 780)。向受试者提供了知情同意书,解释了采用新型手术平台的情况。手术通过重现标准机构多臂机器人辅助部分肾切除术的步骤来进行。

结果

手术成功完成。无需转换为标准多端口机器人手术方法,也无需额外放置端口。所有手术均按照单纯单部位方法完成。术中无并发症发生。机器人手术总时间平均为180分钟。热缺血时间平均为25分钟。失血量平均为180毫升。1例患者术后发生急性出血并接受了血管栓塞治疗。所有患者手术切缘均为阴性。

结论

证明了使用新型SP手术系统进行单纯单部位经腹膜机器人辅助部分肾切除术的可行性。需要进一步研究来证实本文报道的结果。

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