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达芬奇 SP 手术系统行机器人辅助腹腔镜下全子宫切除术和经脐单孔腹腔镜下子宫切除术:单中心病例系列研究。

Robotic LESS and Reduced-Port Hysterectomy Using the da Vinci SP Surgical System: A Single-Institution Case Series.

机构信息

From the Department of Gynecology, Mayo Clinic Arizona, Phoenix, Arizona (all authors).

From the Department of Gynecology, Mayo Clinic Arizona, Phoenix, Arizona (all authors).

出版信息

J Minim Invasive Gynecol. 2021 May;28(5):1095-1100. doi: 10.1016/j.jmig.2020.08.009. Epub 2020 Aug 20.

Abstract

STUDY OBJECTIVE

To present a series of robotic laparoendoscopic single-site surgery (LESS) and reduced-port hysterectomy cases and discuss the surgical technique required for successful use on this new platform.

DESIGN

Retrospective case series.

SETTING

Academic medical center.

PATIENTS

All patients undergoing robotic LESS or reduced-port hysterectomy with the SP1098 da Vinci SP Surgical System (Intuitive Surgical, Sunnyvale, CA) from December 2019 to March 2020.

INTERVENTIONS

Robotic LESS or reduced-port hysterectomy.

MEASUREMENTS AND MAIN RESULTS

A total of 8 cases of hysterectomy were performed successfully. Four cases included concomitant resection of endometriosis. Five cases required placement of an additional port. The average uterine weight was 136.1 g ± 61.5 g (range 87-246). The average estimated blood loss was 37.5 mL ± 27 mL (range 20-100). The average operative time was 86.5 minutes ± 27.1 minutes (range 60-132). The time required for vaginal cuff closure was available for patients 5 to 8, and ranged from 10 minutes to 13 minutes. All patients had same-day discharge. There were no conversions to alternative surgical modality, complications, or readmissions.

CONCLUSION

Our preliminary experience with the SP1098 da Vinci SP Surgical System demonstrated the technical feasibility and safety of this surgical modality for gynecologic surgery. Additional studies examining postoperative outcomes and prospective studies comparing this modality with traditional robotic surgery are indicated.

摘要

研究目的

介绍一系列机器人腹腔镜单部位手术(LESS)和减少端口子宫切除术病例,并讨论在这个新平台上成功使用所需的手术技术。

设计

回顾性病例系列。

设置

学术医疗中心。

患者

2019 年 12 月至 2020 年 3 月期间,所有接受机器人 LESS 或使用 SP1098 da Vinci SP 手术系统(直觉外科公司,加利福尼亚州森尼韦尔)进行减少端口子宫切除术的患者。

干预措施

机器人 LESS 或减少端口子宫切除术。

测量和主要结果

成功完成了 8 例子宫切除术。其中 4 例包括同时切除子宫内膜异位症。5 例需要放置额外的端口。平均子宫重量为 136.1 克±61.5 克(范围 87-246)。平均估计失血量为 37.5 毫升±27 毫升(范围 20-100)。平均手术时间为 86.5 分钟±27.1 分钟(范围 60-132)。阴道残端关闭所需的时间可用于 5 至 8 例患者,范围为 10 分钟至 13 分钟。所有患者均当天出院。无手术方式转换、并发症或再入院。

结论

我们使用 SP1098 da Vinci SP 手术系统的初步经验证明了这种手术方式用于妇科手术的技术可行性和安全性。需要进一步研究来检查术后结果,并进行前瞻性研究来比较这种方式与传统机器人手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5152/7438228/c71c79a6a821/gr1_lrg.jpg

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