Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Urology. 2020 Sep;143:147-152. doi: 10.1016/j.urology.2020.05.041. Epub 2020 Jun 4.
To assess the feasibility and describe the surgical technique for single-port robotic-assisted laparoscopic pyeloplasty using the new da Vinci SP surgical platform (Intuitive Surgical Inc., Sunnyvale, CA), and to describe the approach through a mini-pfannenstiel incision.
Data from a prospectively maintained single-institution database on all patients undergoing single-port robotic-assisted pyeloplasty between November 2018 and November 2019 were reviewed. Pyeloplasty was performed with the da Vinci SP system through a pure single site approach (except for the first patient). The initial procedures were performed through a midline incision and the technique evolved to a mini-pfannenstiel incision. Patient demographics, intraoperative data, post-operative data and surgical outcomes were collected.
Overall, 10 patients were included and underwent the procedure without intraoperative complications or conversion to an alternate approach. The patients' ages ranged between 11 and 75 years. Mean operative time was 166 minutes (interquartile range [IQR] 146-181) and EBL was minimal. Pfannenstiel incision was performed for 6 patients and 4 patients had a vertical midline incision. The only complication recorded was a postoperative urinary tract infection treated with antibiotics. The median postoperative hospital stay was 21 hours (7-24). Postoperative pain management after discharge was managed exclusively with non-opioid medication. Overall success rate defined as the absence of pain and renal obstruction on post-operative imaging at 3 months after surgery was 100%.
Single-port robotic-assisted laparoscopic pyeloplasty is a safe and feasible procedure through a mini-pfannenstiel incision.
评估使用新的达芬奇 SP 手术平台（直觉外科公司，加利福尼亚州森尼韦尔）进行单端口机器人辅助腹腔镜肾盂成形术的可行性，并描述通过迷你 Pfannenstiel 切口的方法。
回顾 2018 年 11 月至 2019 年 11 月期间所有在单机构数据库中接受单端口机器人辅助肾盂成形术的患者的数据。使用达芬奇 SP 系统通过纯单部位方法（除了第一例患者外）进行肾盂成形术。最初的手术通过中线切口进行，技术演变为迷你 Pfannenstiel 切口。收集患者的人口统计学数据、术中数据、术后数据和手术结果。
总共纳入了 10 名患者，在没有术中并发症或转为替代方法的情况下完成了手术。患者年龄在 11 岁至 75 岁之间。平均手术时间为 166 分钟（四分位间距 [IQR] 146-181），出血量极少。6 名患者进行了 Pfannenstiel 切口，4 名患者进行了垂直中线切口。唯一记录的并发症是术后尿路感染，用抗生素治疗。术后中位住院时间为 21 小时（7-24）。出院后的术后疼痛管理仅通过非阿片类药物进行。术后 3 个月影像学检查无疼痛和肾梗阻的总成功率定义为 100%。
通过迷你 Pfannenstiel 切口进行单端口机器人辅助腹腔镜肾盂成形术是一种安全可行的方法。
