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rSILS:单孔机器人(SPr)右半结肠切除术的初步临床经验。

rSILS: initial clinical experience with single-port robotic (SPr) right colectomy.

机构信息

Lankenau Medical Center Division of Colorectal Surgery, Marks Colorectal Surgical Associates, Wynnewood, PA, USA.

出版信息

Tech Coloproctol. 2020 Aug;24(8):817-822. doi: 10.1007/s10151-020-02218-5. Epub 2020 May 25.

Abstract

BACKGROUND

The da Vinci Single-Port (SP) robot is a novel platform designed to facilitate single-incision robotic surgery (rSILS). The objective of this study was to describe our initial experience using this platform for SP robotic (SPr) right colectomy.

METHODS

Under a Food and Drug Administration-regulated feasibility study and Institutional Review Board approval, a patient with cecal adenocarcinoma underwent an SPr right colectomy. The primary endpoint was the safety and feasibility of the first SPr right colectomy performed in the USA. Secondary endpoints included perioperative metrics, morbidity and mortality.

RESULTS

An SPr Standard right colectomy was performed through a 4-cm single incision without the need for conversion or additional port placement. Estimated blood loss was 100 mL and there were no intraoperative complications. The robot was docked once with a docking time of 19 min. Total console time was 116 min and operative time was 219 min. The patient tolerated clear liquids on postoperative day (POD) 0 and a low-residue diet on POD 1. The patient had flatus and a bowel movement on POD 1. She was discharged home on POD 3. Final pathology showed pT3N0 cecal adenocarcinoma with negative margins and 0/24 lymph nodes positive for disease.

CONCLUSIONS

Our initial experience demonstrates that an SPr right colectomy is feasible and can be safely completed. We completed an oncologic resection of a cecal adenocarcinoma without complications. The SP robot facilitates the utilization of robotic technology in a single-incision platform to perform colorectal procedures and offers promising benefits in the advancement of robotic surgery.

摘要

背景

达芬奇单端口(SP)机器人是一种新型平台,旨在促进单切口机器人手术(rSILS)。本研究的目的是描述我们使用该平台进行 SP 机器人(SPr)右结肠切除术的初步经验。

方法

根据食品和药物管理局监管的可行性研究和机构审查委员会的批准,一名患有盲肠腺癌的患者接受了 SPr 右结肠切除术。主要终点是在美国首次进行的 SPr 右结肠切除术的安全性和可行性。次要终点包括围手术期指标、发病率和死亡率。

结果

通过一个 4 厘米的单一切口进行了 SPr 标准右结肠切除术,无需转换或额外放置端口。估计失血量为 100 毫升,术中无并发症。机器人一次对接,对接时间为 19 分钟。控制台总时间为 116 分钟,手术时间为 219 分钟。患者在术后第 0 天(POD)耐受清亮液体,在 POD 1 耐受低残留饮食。患者在 POD 1 时放屁和排便。患者在 POD 3 出院回家。最终病理显示 pT3N0 盲肠腺癌,切缘阴性,24 个淋巴结中有 0/24 个淋巴结有疾病。

结论

我们的初步经验表明,SPr 右结肠切除术是可行的,可以安全完成。我们完成了一例盲肠腺癌的肿瘤切除术,没有并发症。SP 机器人有助于在单切口平台上利用机器人技术进行结直肠手术,并为机器人手术的发展提供了有前途的益处。

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