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单孔机器人(SP r)左结肠切除术的初步临床经验:技术描述。

Initial clinical experience with Single-Port robotic (SP r) left colectomy using the SP surgical system: description of the technique.

机构信息

The Colorectal Center at Lankenau Medical Center, Division of Colorectal Surgery, Medical Science Building, Suite 375, 100 East Lancaster Avenue, Wynnewood, PA, 19096, USA.

出版信息

Surg Endosc. 2021 Jul;35(7):4022-4027. doi: 10.1007/s00464-020-08159-2. Epub 2020 Nov 19.

Abstract

BACKGROUND

The daVinci Single-Port (SP) robot is a new robotic platform designed to overcome the challenges of Single-Incision Laparoscopic Surgery. The objective of this study is to demonstrate the feasibility and technical aspects of SP robotic (SP r) left colectomy using the SP platform.

METHODS

Under Institutional Review Board approval and registration on ClinicalTrials.gov, we performed SP rLeft colectomy using the daVinci SP surgical system on four patients. The primary end-point of this study was to report and describe the technical feasibility to perform SP rLeft colectomy. The secondary end-points included perioperative metrics and outcomes.

RESULTS

Four patients underwent successful SP rLeft colectomy for diverticulitis through a single incision (average size: 4.4 cm) without intraoperative complications or conversions. The robot was docked 2.7 times on average (range 2-4). The average docking time was 8.4 min (range: 3-33 min). The mean estimated blood loss was 91 mL (range: 20-250 mL). There were no morbidities or mortalities. Patients were discharged on POD 2 and 3.

CONCLUSION

We demonstrated in this initial clinical series the SP rLeft colectomy to be feasible and safe to perform in select patients. The SP robot's single-arm design and flexible instruments have shown to provide excellent visualization and retraction with minimal collisions. We predict that the SP robot will be widely utilized in the field of colorectal surgery as it becomes available to colorectal surgeons. Further experience and larger studies are needed to define the advantages and identify the problems with the SP rLeft colectomy.

摘要

背景

达芬奇单孔(SP)机器人是一种新的机器人平台,旨在克服单孔腹腔镜手术的挑战。本研究的目的是展示使用 SP 平台进行 SP 机器人(SP r)左结肠切除术的可行性和技术方面。

方法

在机构审查委员会批准和 ClinicalTrials.gov 注册的情况下,我们对四名患者使用达芬奇 SP 手术系统进行了 SP r 左结肠切除术。本研究的主要终点是报告和描述进行 SP r 左结肠切除术的技术可行性。次要终点包括围手术期指标和结果。

结果

四名患者因憩室炎成功接受了单切口(平均大小:4.4 厘米)的 SP r 左结肠切除术,无术中并发症或转为开腹手术。机器人平均对接 2.7 次(范围 2-4 次)。平均对接时间为 8.4 分钟(范围:3-33 分钟)。平均估计出血量为 91 毫升(范围:20-250 毫升)。无并发症或死亡。患者于术后第 2 天和第 3 天出院。

结论

在本初步临床系列中,我们证明 SP r 左结肠切除术在选择的患者中是可行且安全的。SP 机器人的单臂设计和灵活的器械已被证明可提供出色的可视化和牵开效果,最小化碰撞。我们预测,随着 SP 机器人在结直肠外科领域的普及,它将得到广泛应用。需要进一步的经验和更大的研究来确定 SP r 左结肠切除术的优势,并发现其存在的问题。

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