Department of Surgery, Division of Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA; South East Clinical Research Associates, Inc, Houston, TX, USA.
Department of Surgery, Division of Minimally Invasive Colon and Rectal Surgery, The University of Texas Medical School at Houston, Houston, TX, USA; Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, TX, USA; South East Clinical Research Associates, Inc, Houston, TX, USA.
Am J Surg. 2019 Apr;217(4):670-676. doi: 10.1016/j.amjsurg.2018.11.048. Epub 2018 Dec 14.
Despite numerous benefits, only a small fraction of laparoscopic left-sided colectomy is accomplished without the need for an abdominal incision to retrieve the specimen and prepare for anastomosis. We report our early experience with a robotic approach using Natural orifice IntraCorporeal anastomosis with Extraction of specimen (NICE) to help overcome the technical limitations and challenges of this approach.
Twenty consecutive patients presented for elective sigmoid or rectosigmoid resection for benign and malignant disease and underwent the NICE procedure. Safety, feasibility and post-operative outcomes were analyzed.
Intracorporeal anastomosis was accomplished in all patients. One patient required an abdominal incision to extract a bulky tumor. Mean operative time was 222 min (146-344). Mean time to first flatus and length of stay was 23 and 49 h, respectively. All but 4 patients were discharged home on post-operative day 2. One patient was readmitted with a pelvic fluid collection.
Robotic left-sided colorectal resection with NICE procedure is a safe and feasible minimally invasive approach and may facilitate greater adoption rates of this technique.
尽管腹腔镜左半结肠切除术有许多益处，但只有一小部分需要开腹切口来取出标本并准备吻合。我们报告了使用自然腔道内镜手术（NICE）机器人技术的早期经验，以帮助克服该技术的技术限制和挑战。
20 例连续患者因良性和恶性疾病接受选择性乙状结肠或直肠乙状结肠切除术，并进行了 NICE 手术。分析了安全性、可行性和术后结果。
所有患者均完成了腔内吻合。1 例患者因肿瘤体积较大而需要开腹切口。平均手术时间为 222 分钟（146-344 分钟）。首次排气时间和住院时间的平均值分别为 23 小时和 49 小时。除 4 例患者外，其余患者均在术后第 2 天出院回家。1 例患者因盆腔积液再次入院。
NICE 机器人左半结直肠切除术是一种安全可行的微创方法，可能会提高该技术的采用率。
