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达芬奇 SP 根治性前列腺切除术的当代技术:多中心合作与专家意见

Contemporary techniques of da Vinci SP radical prostatectomy: multicentric collaboration and expert opinion.

作者信息

Moschovas Marcio Covas, Brady Isabella, Noel Jonathan, Zeinab Mahmoud Abou, Kaviani Aaron, Kaouk Jihad, Crivellaro Simone, Joseph Jean, Mottrie Alexandre, Patel Vipul

机构信息

AdventHealth Global Robotics Institute (GRI), Celebration, USA.

University of Central Florida (UCF), Orlando, USA.

出版信息

Int Braz J Urol. 2022 Jul-Aug;48(4):696-705. doi: 10.1590/S1677-5538.IBJU.2022.99.16.

Abstract

BACKGROUND

The da Vinci SP robot consists of an innovative single port trocar that houses a flexible camera and three biarticulated arms, which minimizes the number of incisions to assess the surgical site, allowing a less invasive procedure. However, due to its recent release in the market, the current literature reporting SP-RARP is still restricted to a few centers. In this scenario, after performing a literature search with all available techniques of SP-RARP, our objective is to report a multicentric opinion of referral centers on different techniques to approach SP-RARP.

RESULTS

The SP literature is provided by only a few centers due to the limited number of this new console in the market. Five different approaches are available: transperitoneal, extraperitoneal, Retzius-Sparing, transperineal and transvesical. None of the current studies describe long-term functional or oncological outcomes. However, all approaches had satisfactory operative performance with minimum complication rates.

CONCLUSIONS

Several techniques of SP-RARP have been reported in the literature. We performed a multicentric collaboration describing and illustrating the most challenging steps of this surgery. We believe that the details provided in this article are useful teaching material for new centers willing to adopt the SP technology.

摘要

背景

达芬奇SP机器人由一个创新的单孔套管针组成,该套管针容纳一个灵活的摄像头和三个双关节臂,可将评估手术部位的切口数量减至最少,从而实现侵入性较小的手术。然而,由于其最近才投放市场,目前报道单孔腹腔镜根治性前列腺切除术(SP-RARP)的文献仍局限于少数几个中心。在这种情况下,在对SP-RARP的所有可用技术进行文献检索后,我们的目标是报告转诊中心对不同SP-RARP技术的多中心观点。

结果

由于市场上这种新设备数量有限,SP的文献仅由少数几个中心提供。有五种不同的方法:经腹腔、腹膜外、保留Retzius间隙、经会阴和经膀胱。目前尚无研究描述长期功能或肿瘤学结果。然而,所有方法的手术效果均令人满意,并发症发生率最低。

结论

文献中已报道了几种SP-RARP技术。我们进行了一项多中心合作,描述并展示了该手术最具挑战性的步骤。我们相信本文提供的细节对于愿意采用SP技术的新中心来说是有用的教学材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/905f/9306371/1579d45f0629/1677-6119-ibju-48-04-0696-gf01.jpg

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