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妇科经脐单孔腹腔镜手术中内置抓持器和磁锚定引导系统:病例系列研究。

Internal Grasper and Magnetic Anchoring Guidance System in Gynecologic Laparoendoscopic Single-site Surgery: A Case Series.

机构信息

Department of Obstetrics and Gynecology (Drs. L. Zhang, L. Wang, Zhao, Y. Wang, K. Zhang, Feng, and Li).

Department of Hepatobiliary Surgery (Drs. Yan and Lv), First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

J Minim Invasive Gynecol. 2021 May;28(5):1066-1071. doi: 10.1016/j.jmig.2020.09.022. Epub 2020 Oct 31.

DOI:10.1016/j.jmig.2020.09.022
PMID:33137464
Abstract

STUDY OBJECTIVE

To evaluate and report preliminary data after the use of an internal grasper and magnetic anchoring guidance system (MAGS) to allow free movement and optimal triangulation in the abdominal cavity during gynecologic laparoendoscopic single-site surgery (LESS).

DESIGN

A prospective, single-center case series.

SETTING

The First Affiliated Hospital of Xi'an Jiaotong University.

PATIENTS

Eighteen female patients underwent MAGS-assisted LESS with an internal grasper.

INTERVENTIONS

A single surgeon performed MAGS-assisted LESS on patients with benign gynecologic diseases while documenting operative time, device insertion time, surgeon assessment of technical adaptation, patient-evaluated pain and cosmetic outcomes, adverse events, and blood loss.

MEASUREMENTS AND MAIN RESULTS

Eighteen patients underwent transumbilical MAGS-assisted LESS using an internal grasper from November 1, 2019, to December 31, 2019. The mean operative time and insertion time were 98.7 minutes and 1 minute, respectively. The use of MAGS was easily mastered by the surgeon and considered consistently useful in overcoming the limitations of LESS. The patients reported average pain scores of 4.8, 2.3, and 0.5 immediately, 24 hours, and 1 week after surgery, respectively. All patients expressed satisfaction with the postoperative cosmetic results. No serious complications were observed. The mean blood loss was 43.6 mL.

CONCLUSION

MAGS-assisted LESS is easy to deploy and use for benign gynecologic disease and seems to result in positive outcomes. Larger randomized controlled trials are warranted.

摘要

研究目的

评估并报告使用内置抓握器和磁锚定引导系统(MAGS)后的数据,以在妇科腹腔镜单部位手术(LESS)中允许腹部自由移动和最佳三角化。

设计

前瞻性、单中心病例系列。

设置

西安交通大学第一附属医院。

患者

18 名女性患者接受了 MAGS 辅助 LESS 和内置抓握器。

干预措施

一名外科医生对患有良性妇科疾病的患者进行 MAGS 辅助 LESS,记录手术时间、器械插入时间、外科医生对技术适应性的评估、患者评估的疼痛和美容效果、不良事件和出血量。

测量和主要结果

从 2019 年 11 月 1 日至 12 月 31 日,18 名患者接受了经脐 MAGS 辅助 LESS 采用内置抓握器。平均手术时间和插入时间分别为 98.7 分钟和 1 分钟。外科医生很容易掌握 MAGS 的使用,并认为它在克服 LESS 的局限性方面始终很有用。患者报告的平均疼痛评分分别为术后立即 4.8 分、24 小时后 2.3 分和 1 周后 0.5 分。所有患者对术后美容效果均表示满意。未观察到严重并发症。平均出血量为 43.6 毫升。

结论

MAGS 辅助 LESS 易于部署和用于治疗良性妇科疾病,似乎产生了积极的结果。需要更大规模的随机对照试验。

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