Kataoka Atsuko, Hirano Yasumitsu, Kondo Hiroka, Shimamura Satoshi, Kataoka Masahiro, Asari Masahiro, Fujii Takatsugu, Ishikawa Shintaro, Ishii Toshimasa, Yamaguchi Shigeki
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Surg Case Rep. 2020 Oct 7;6(1):263. doi: 10.1186/s40792-020-01037-y.
The evolution of remote systems and artificial intelligence technology has led to increase in robotic surgeries. One system used in this case report is the Senhance robotic system. The most important premise for using robotic surgery in cancer therapeutics is to ensure oncological safety. Similar to conventional laparoscopic surgery, robotic surgery needs to be a reliable and secure surgical procedure, such as complete mesocolic excisions with central vascular ligations in Western countries or D3 lymph node dissections (dissection of the lymph nodes that locates from the origin to the terminal branch of the main feeding artery of cancer) in Japan.
A 76-year-old man underwent clinical examination for severe anemia. He was diagnosed with transverse colon cancer of tumor (T)3, node (N)1a, metastasis (M)0 cancer stage IIIA. A right hemicolectomy with D3 lymph node dissection using the Senhance surgical system was performed. The operative time was 313 min and the estimated blood loss was 5 ml. He was discharged from our hospital 12 days after the surgery without any complications. What is the remarkable of this report, not only mobilization of right colon but also D3 lymph node dissection and vascular ligation were performed intraperitoneally by using Senhance robotic system as conventional laparoscopic surgery. We tried using fourth robotic arm to accomplish lymphadenectomies and middle colic artery dissection. A right hemicolectomy with D3 dissection using the Da Vinci surgical system was reported. Another report of a right hemicolectomy performed with the Senhance robotic system was identified; however, in that study, lymph node dissections were not performed intraperitoneally.
Therefore, to our knowledge, this is the first report using the Senhance robotic system for right hemicolectomy with D3 dissection. We hope that our case report will assist in the establishment of this robotic procedure in surgical practice.
远程系统和人工智能技术的发展导致机器人手术的增加。本病例报告中使用的一个系统是森海斯机器人系统。在癌症治疗中使用机器人手术的最重要前提是确保肿瘤学安全性。与传统腹腔镜手术类似，机器人手术需要是一种可靠且安全的手术程序，例如在西方国家进行完整的结肠系膜切除并结扎中央血管，或在日本进行D3淋巴结清扫术（清扫从癌症主要供血动脉起点到终末分支的淋巴结）。
一名76岁男性因严重贫血接受临床检查。他被诊断为肿瘤（T）3、淋巴结（N）1a、转移（M）0的IIIA期横结肠癌。使用森海斯手术系统进行了D3淋巴结清扫的右半结肠切除术。手术时间为313分钟，估计失血量为5毫升。术后12天他从我院出院，无任何并发症。本报告的显著之处在于，不仅像传统腹腔镜手术一样通过使用森海斯机器人系统在腹腔内进行了右半结肠的游离，还进行了D3淋巴结清扫和血管结扎。我们尝试使用第四机械臂完成淋巴结清扫和中结肠动脉的解剖。有报道使用达芬奇手术系统进行了D3清扫的右半结肠切除术。还发现了另一篇使用森海斯机器人系统进行右半结肠切除术的报告；然而，在该研究中，未在腹腔内进行淋巴结清扫。
因此，据我们所知，这是第一篇使用森海斯机器人系统进行D3清扫右半结肠切除术的报告。我们希望我们的病例报告将有助于在外科实践中确立这种机器人手术方法。
