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机器人 TAPP 腹股沟疝修补术:97 例经验教训。

Robotic TAPP inguinal hernia repair: lessons learned from 97 cases.

机构信息

- Instituto Morrell, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil.

- Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, Cirurgia Geral e Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil.

出版信息

Rev Col Bras Cir. 2021 Jan 29;48:e20202704. doi: 10.1590/0100-6991e-20202704. eCollection 2021.

Abstract

OBJECTIVES

minimally invasive inguinal hernia repair has proven advantages over open procedures including less pain and earlier return to normal activity. Robotic surgery adds ergonomics, a three-dimensional high definition camera and articulating instruments overcoming some laparoscopic limitations. We aimed to report the outcomes of the early experience of over 97 robotic inguinal hernia repairs performed by a referred surgical group in Brazil.

METHODS

a review of a prospective mantined database was conducted in patients submitted to robotic transabdominal preperitoneal (TAPP) inguinal hernia repairs between March 2016 and February 2020. Descriptive statistics were performed. Surgical outcomes data and patient follow-ups are reported.

RESULTS

retrospective chart review identified 97 patients submitted to robotic TAPP inguinal hernia repair. Mean age was 36.4 years, with median BMI of 26.9 kg/m2. Mean console time was 58 min (range 40-150) and patients were discharged within 24 hours of their stay in a majority of cases. Mesh was placed in all procedures and there were no conversion rates. Complications were low grade and no recurrence was seen after a mean follow-up of 642 days.

CONCLUSION

this study represents to-date the first brazilian case series of robotic TAPP inguinal hernia repair. Our results encourage that robotic assisted TAPP inguinal hernia repair appears to be technically feasible and safe in experienced hands, with good outcomes achieving high health-related quality of life and low recurrence rates in the short and long term.

摘要

目的

微创腹股沟疝修补术已被证明优于开放手术,包括疼痛减轻和更早恢复正常活动。机器人手术增加了人体工程学、三维高清摄像头和铰接器械,克服了一些腹腔镜的局限性。我们旨在报告由巴西一个转诊外科组进行的超过 97 例机器人腹股沟疝修补术早期经验的结果。

方法

对 2016 年 3 月至 2020 年 2 月期间接受机器人经腹腹膜前(TAPP)腹股沟疝修补术的患者进行前瞻性维护数据库的回顾性研究。进行描述性统计。报告手术结果数据和患者随访情况。

结果

回顾性图表审查确定了 97 例接受机器人 TAPP 腹股沟疝修补术的患者。平均年龄为 36.4 岁,中位数 BMI 为 26.9kg/m2。平均控制台时间为 58 分钟(范围 40-150),大多数患者在住院 24 小时内出院。所有手术均放置补片,无转化率。并发症为低级别,在平均 642 天的随访后未见复发。

结论

本研究代表了迄今为止巴西首例机器人 TAPP 腹股沟疝修补术的病例系列。我们的结果表明,在有经验的医生手中,机器人辅助 TAPP 腹股沟疝修补术在技术上是可行和安全的,具有良好的结果,可实现高健康相关生活质量和低复发率,无论是短期还是长期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abf7/10683431/6619482634ef/rcbc-48-e20202704-g001.jpg

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