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经新型机器人手术平台行骶骨阴道固定术的经验

Sacrocolpopexy experience with a novel robotic surgical platform.

机构信息

Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

出版信息

Int Urogynecol J. 2022 Nov;33(11):3255-3260. doi: 10.1007/s00192-022-05155-z. Epub 2022 Mar 21.

Abstract

INTRODUCTION AND HYPOTHESIS

The objective was to describe early experience performing sacrocolpopexy using a novel robotic surgical platform.

METHODS

This is a case series of all women who underwent robotic-assisted sacrocolpopexy using a new robotics platform (TransEnterix Senhance) between January 2019 and July 2021. All sacrocolpopexies were performed by a single Female Pelvic Medicine and Reconstructive surgeon at a large academic institution. Perioperative information including complications was abstracted from the medical record. Anatomical recurrence was defined as any anatomical point at or past the hymen (≥0). Data are descriptive, with Mann-Whitney U test used for comparison of operative time between the first and second half of the patients.

RESULTS

A total of 25 sacrocolpopexies were performed using the new robotics platform. Mean age was 62.3 years (±9.2) and mean BMI was 26.5 (±3.8). Ten (40.0%) patients had a prior hysterectomy. Most (n = 21, 84.0%) had stage III or IV prolapse preoperatively. Mean operative time was 210.2 min (±48.6) and median estimated blood loss was 35 ml (IQR 25-50). Mean operative time decreased between the first and second half of the patients (231.7 min vs 190.3 min, p = 0.047). There were no major intraoperative complications. Median follow-up time was 16 weeks (IQR 4-34) and there were no subjective recurrences or retreatments during this period. Two patients (8.0%) had anatomical recurrence without subjective bother. There were two postoperative readmissions (8.0%) within 30 days for small bowel obstruction, one treated surgically and the other with nonsurgical management.

CONCLUSIONS

Our case series demonstrates feasibility and successful early adoption of a new robotics platform for robotic sacrocolpopexy.

摘要

介绍和假设

目的是描述使用新型机器人手术平台进行骶骨阴道固定术的早期经验。

方法

这是一项回顾性病例系列研究,纳入 2019 年 1 月至 2021 年 7 月期间在一家大型学术机构由同一位女性盆底医学和重建外科医生使用新型机器人平台(TransEnterix Senhance)进行的机器人辅助骶骨阴道固定术的所有女性患者。从病历中提取围手术期信息,包括并发症。解剖学复发定义为任何在处女膜(≥0)或处女膜后的解剖学部位。数据为描述性的,采用 Mann-Whitney U 检验比较患者前半部分和后半部分的手术时间。

结果

共有 25 例骶骨阴道固定术使用新型机器人平台完成。平均年龄为 62.3 岁(±9.2),平均 BMI 为 26.5(±3.8)。10 例(40.0%)患者有子宫切除术史。大多数(n=21,84.0%)术前患有 III 期或 IV 期脱垂。平均手术时间为 210.2 分钟(±48.6),中位估计失血量为 35 毫升(IQR 25-50)。患者前半部分和后半部分的手术时间呈下降趋势(231.7 分钟比 190.3 分钟,p=0.047)。无重大术中并发症。中位随访时间为 16 周(IQR 4-34),在此期间无主观复发或再次治疗。2 例(8.0%)患者出现无主观不适的解剖学复发。术后 30 天内有 2 例(8.0%)再入院,均为小肠梗阻,1 例手术治疗,1 例非手术治疗。

结论

我们的病例系列研究表明,使用新型机器人平台进行机器人骶骨阴道固定术是可行的,并且早期采用效果良好。

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