Liu Zhongyu, Tian Shuang, Yan Zhifeng, Yu Xiurong, Li Xiuli, Tao Ye
Department of Obstetrics and Gynecology, PLA General Hospital, Beijing 100853, PR China,
Department of Anesthesia Surgery Center, Hainan Branch of PLA General Hospital, Sanya 572013, PR China.
Ther Clin Risk Manag. 2019 Jan 24;15:179-185. doi: 10.2147/TCRM.S176852. eCollection 2019.
To report the first case series of robotic single-site (RSS) surgery via the da Vinci Si Surgical System for mature cyst teratoma cystectomy in China.
The study was devised as a retrospective study in a single medical center. Five patients with mature cyst teratomas requested a minimally invasive surgical treatment. These patients were treated with RSS surgery for mature cyst teratoma between January 2014 and January 2015. RSS mature cyst teratoma cystectomies were performed with the da Vinci single-site platform in the Hainan branch of PLA General Hospital. Data regarding patient characteristics, surgical approach, and perioperative clinical outcomes were collected and analyzed in a retrospective study.
All RSS procedures were completed successfully in the five patients. No instrument failure was noted during the procedures. The median operating time was 65 minutes (range 45-100 minutes). The median docking time was 20 minutes (range 18-28 minutes). No instrument failure was noted during any surgical procedures. The median blood loss was 30 mL (range 10-70 mL). No patient had massive intraoperative bleeding nor required a transfusion. No extra trocar was placed during the surgery. None of the patients had bladder or rectal injury. The median length of stay in hospital was 2.8 days. All patients were followed up until 6 months postoperatively, and no surgical complication occurred.
RSS mature cyst teratoma cystectomy using the wristed semirigid instrumentation is feasible. Randomized controlled trials with a larger number of patients and longer postoperative follow-up should be conducted to further evaluate the effect of this therapeutic strategy.
报告中国首例通过达芬奇Si手术系统进行机器人单孔（RSS）手术切除成熟性囊性畸胎瘤的病例系列。
本研究设计为在单一医疗中心进行的回顾性研究。5例成熟性囊性畸胎瘤患者要求进行微创手术治疗。这些患者于2014年1月至2015年1月期间接受了RSS手术切除成熟性囊性畸胎瘤。解放军总医院海南分院采用达芬奇单孔平台进行了RSS成熟性囊性畸胎瘤切除术。在一项回顾性研究中收集并分析了患者特征、手术方式及围手术期临床结局等数据。
5例患者的所有RSS手术均成功完成。手术过程中未发现器械故障。中位手术时间为65分钟（范围45 - 100分钟）。中位对接时间为20分钟（范围18 - 28分钟）。任何手术过程中均未发现器械故障。中位失血量为30毫升（范围10 - 70毫升）。无患者术中大出血或需要输血。手术过程中未放置额外的套管针。所有患者均未出现膀胱或直肠损伤。中位住院时间为2.8天。所有患者均随访至术后6个月，未发生手术并发症。
使用腕部半刚性器械进行RSS成熟性囊性畸胎瘤切除术是可行的。应开展更多患者、更长术后随访时间的随机对照试验，以进一步评估该治疗策略的效果。
