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机器人在小儿泌尿外科中的应用。

Robotics in Pediatric Urology.

机构信息

Nationwide Children's Hospital, Columbus, OH, USA.

出版信息

Int Braz J Urol. 2020 May-Jun;46(3):322-327. doi: 10.1590/S1677-5538.IBJU.2020.99.03.

Abstract

Robotic surgery has been slow to be fully accepted in the world of pediatric urology largely because of its initial application directed towards adult use and because of the inherent high cost associated with it. However, as previously shown, it has now become the gold standard for adolescent pyeloplasty in The United States. As the adoption of robotic surgery in children has become more widespread, its use has been applied to a broader spectrum of procedures with similar success rates to standard laparoscopy. These procedures include nephrectomy, heminephrectomy, ureteral reimplantation, and ureteroureterostomy. However, it has also shown feasibility and comparable success when compared to open surgery in procedures that were previously deemed too complex to be done by standard laparoscopy. For example, bladder neck reconstruction with Mitrofanoff and Malone procedure as well as bladder augmentation. This review objective is to provide an overview of robotic surgery in pediatric urology, with a focus on the more common cases such as pyeloplasty and reimplantation as well as more complex bladder reconstruction procedures.

摘要

机器人手术在小儿泌尿外科领域的普及速度较慢,主要是因为其最初的应用方向是针对成人使用,而且其本身的成本也很高。然而,正如之前所表明的,它现在已经成为美国青少年肾盂成形术的金标准。随着机器人手术在儿童中的应用越来越广泛,其应用范围也扩大到了更广泛的手术领域,其成功率与标准腹腔镜手术相似。这些手术包括肾切除术、半肾切除术、输尿管再植入术和输尿管-输尿管吻合术。然而,与开放手术相比,它在以前被认为过于复杂而无法通过标准腹腔镜手术完成的手术中也显示出了可行性和可比的成功率。例如,膀胱颈部重建术与米托法诺夫和马龙手术以及膀胱扩张术。本综述的目的是提供小儿泌尿外科机器人手术的概述,重点介绍肾盂成形术和再植入术等常见病例,以及更复杂的膀胱重建手术。

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