Kira Satoru, Mitsui Takahiko, Sawada Norifumi, Nakagomi Hiroshi, Ihara Tatsuya, Takahashi Nobuhiro, Takeda Masayuki
Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
Int J Med Robot. 2020 Jun;16(3):e2092. doi: 10.1002/rcs.2092. Epub 2020 Mar 1.
To investigate the feasibility of the fourth arm of the da Vinci Si system for robot-assisted partial nephrectomy (RAPN).
Fifty-eight consecutive patients underwent RAPN with the same port placements. After reviewing the surgical videos and records, 38 patients showing usefulness of the fourth arm were categorized into Group A and those not showing usefulness into Group B. The background data, tumor characteristics, and perioperative outcomes were compared between the groups.
Group B had a larger proportion of tumors located on the inner side of the kidney, and the console time was significantly longer. Multivariable logistic regression analysis showed that tumors located on the inner side of the kidney were associated with the non-use of the fourth arm of the da Vinci Si system during RAPN.
Our findings suggested that use of fourth arm in RAPN by da Vinci Si should be considered for each tumor location.
探讨达芬奇Si系统第四臂用于机器人辅助部分肾切除术（RAPN）的可行性。
58例连续患者接受了相同端口放置的RAPN。在回顾手术视频和记录后，38例显示第四臂有用的患者被归入A组，未显示有用性的患者被归入B组。比较两组的背景数据、肿瘤特征和围手术期结果。
B组位于肾内侧的肿瘤比例更大，控制台时间明显更长。多变量逻辑回归分析显示，肾内侧的肿瘤与RAPN期间未使用达芬奇Si系统的第四臂有关。
我们的研究结果表明，应根据每个肿瘤的位置考虑在RAPN中使用达芬奇Si系统的第四臂。
