Liu Juan, Tan Liping, Thigpen Brooke, Koythong Tamisa, Zhou Xingnan, Liu Qihuang, Wang Qianqing, Guan Xiaoming
Department of Obstetrics and Gynaecology, Baylor College of Medicine, Houston, Texas, USA.
Department of Obstetrics and Gynaecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Int J Med Robot. 2022 Jun;18(3):e2385. doi: 10.1002/rcs.2385. Epub 2022 Mar 8.
To explore the learning curve and safety outcomes of robotic assisted transvaginal natural orifice transluminal endoscopic surgery (R-vNOTES) for hysterectomy in benign gynaecological diseases.
A retrospective chart review of all patients undergoing R-vNOTES hysterectomy for benign gynaecological disease from 2019 to 2021.
An academic tertiary care university hospital in Houston, TX, USA.
84 patients were identified that met the study requirements. The mean hysterectomy time was 77.27 ± 2.89 min. The median additional operation time was 63 (8-206) min. There were two conversions to robotic assisted single incision laparoscopy. Thirteen (15.48%) patients had an associated complication. Analysis of the learning curve suggests plateauing of hysterectomy time at approximately 10 cases and time for robot docking and port placement after 10-20 cases.
R-vNOTES is a safe and effective route for hysterectomy. For a surgeon with experience in laparoscopic single site surgery and abdominal robotic surgery, they need to perform 10 cases of R-vNOTES hysterectomy and 10-20 cases in port placement and robotic docking to achieve proficiency.
探讨机器人辅助经阴道自然腔道内镜手术（R-vNOTES）治疗良性妇科疾病子宫切除术的学习曲线和安全结果。
对2019年至2021年期间所有接受R-vNOTES子宫切除术治疗良性妇科疾病的患者进行回顾性病历审查。
美国得克萨斯州休斯顿的一家学术性三级护理大学医院。
确定了84例符合研究要求的患者。平均子宫切除时间为77.27±2.89分钟。额外手术时间的中位数为63（8-206）分钟。有2例转为机器人辅助单孔腹腔镜手术。13例（15.48%）患者出现相关并发症。学习曲线分析表明，子宫切除时间在大约10例时趋于平稳，机器人对接和端口放置时间在10-20例后趋于平稳。
R-vNOTES是一种安全有效的子宫切除途径。对于有腹腔镜单孔手术和腹部机器人手术经验的外科医生，他们需要进行10例R-vNOTES子宫切除术以及10-20例端口放置和机器人对接手术才能达到熟练水平。
