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达芬奇 Xi®系统机器人单部位胆囊切除术的早期结果。

Early Outcomes of Robotic Single Site Cholecystectomy Using the DaVinci Xi® System.

机构信息

Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea.

出版信息

JSLS. 2021 Jan-Mar;25(1). doi: 10.4293/JSLS.2020.00082.

Abstract

PURPOSE

Robotic surgery has become an established alternative to conventional laparoscopy or single site laparoscopy by solving the problems of angulation, improving the ergonomics of single-incision technology, and overcoming the intrinsic limitations of single-incision laparoscopy. Although the robotic single site technology is non-wristed and, unlike other conventional robotic instruments, only provides rotation, the ergonomics are nevertheless excellent. Therefore, the objective of this study is to present our initial experience in robotic single site cholecystectomy (RSSC) by a surgeon. Through this, we suggest that RSSC could be a feasible and safe procedure for overcoming the shortcomings of single incision laparoscopic cholecystectomy (SILC).

METHODS

This study is a retrospective data review of 74 patients who underwent RSSC between April 2019 and August 2020 at our institution. The demographic, pre-, and postoperative data were retrospectively collected.

RESULTS

A total of 74 patients underwent RSSC. The mean age of patients was 44.7 ± 9.5 years, and their mean body mass index was 24 ± 3 kg/m. Symptomatic gallbladder stone (56.8%) was the most common pre-operative diagnosis. Mean of total operation and docking times was 39.3 ± 12.5 (20 - 85) and 7.6 ± 3.1 (4 - 20) minutes, respectively. There was no conversion, additional port insertion, bleeding, or intra-operative complication; however, one patient had wound seroma.

CONCLUSIONS

RSSC for uncomplicated gallbladder disease may serve as an excellent alternative to SILC or conventional laparoscopic cholecystectomy because of its low complication rates, good cosmesis, and ease of reproducibility without a substantial learning curve.

摘要

目的

机器人手术通过解决角度问题、改善单切口技术的人体工程学以及克服单切口腹腔镜检查的固有局限性,已成为传统腹腔镜或单部位腹腔镜的一种既定替代方法。虽然机器人单部位技术无腕关节,并且与其他常规机器人器械不同,仅提供旋转,但人体工程学仍然非常出色。因此,本研究的目的是通过外科医生介绍机器人单部位胆囊切除术(RSSC)的初步经验。通过这种方式,我们认为 RSSC 可能是一种可行且安全的手术方法,可以克服单切口腹腔镜胆囊切除术(SILC)的缺点。

方法

本研究回顾性分析了 2019 年 4 月至 2020 年 8 月在我院接受 RSSC 的 74 例患者的资料。回顾性收集了患者的人口统计学、术前和术后数据。

结果

共有 74 例患者接受了 RSSC。患者的平均年龄为 44.7±9.5 岁,平均体重指数为 24±3kg/m。有症状的胆囊结石(56.8%)是最常见的术前诊断。总手术和对接时间的平均值分别为 39.3±12.5(20-85)和 7.6±3.1(4-20)分钟。没有转换、额外的端口插入、出血或术中并发症;然而,有 1 例患者出现伤口血清肿。

结论

对于简单的胆囊疾病,RSSC 可能是 SILC 或传统腹腔镜胆囊切除术的极好替代方法,因为它具有较低的并发症发生率、良好的美容效果以及易于复制,而没有明显的学习曲线。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe19/7881280/4db3af1d32eb/LS-JSLS200023F001.jpg

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