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单孔机器人辅助根治性前列腺切除术的初步经验:一位外科医生的技术描述经验

Initial experience of single-port robot-assisted radical prostatectomy: A single surgeon's experience with technique description.

作者信息

Noh Tae Il, Tae Jong Hyun, Shim Ji Sung, Kang Seok Ho, Cheon Jun, Lee Jeong Gu, Kang Sung Gu

机构信息

Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea.

出版信息

Prostate Int. 2022 Jun;10(2):85-91. doi: 10.1016/j.prnil.2021.10.003. Epub 2022 Jan 5.

Abstract

BACKGROUND

With the implementation of da Vinci SP robot platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA), we described our initial experience with the da Vinci SP robot platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA) for single-port robotic-assisted radical prostatectomy (SP-RARP).

METHODS

This retrospective review included 30 consecutive patients with prostate biopsy-confirmed prostate cancer who underwent SP-RARP by a single surgeon between June and November 2020. SP-RARP was performed with a single-incision plus one method, in which the multichannel guide port was inserted directly with an additional assist port. We report our initial experience of perioperative and early functional outcomes.

RESULTS

The mean operative time (SD), console time (SD), and blood loss were 142.8 (15.1) min, 109.9 (15.7) min, and 133.0 (72.9) mL, respectively. No intraoperative complications or blood transfusions were reported. Of the 30 patients, 21 (70.0%), 7 (23.3%) and 2 (6.7%) had stage pT2, pT3a and pT3b disease, respectively. Positive surgical margins were reported in 5 of the 30 (16.7%) patients in the final pathology report, including 2 of 21 (9.5%) with stage pT2 and 3 of 9 (33.3%) with ≥ pT3. At 12 weeks after SP-RARP, 80.0% of patients had achieved continence and the potency was 46.7%; 8 of 11 (72.7%) had sexual health inventory for men (SHIM) scores ≥ 17 and 6 of 19 (31.6%) had SHIM scores < 17.

CONCLUSIONS

The SP platform for radical prostatectomy was technically safe and feasible. After overcoming the technical learning curve, this platform may provide high-quality outcomes comparable to those of multi-port platforms.

摘要

背景

随着达芬奇SP机器人平台(直观外科公司,美国加利福尼亚州森尼韦尔)的应用,我们描述了我们使用达芬奇SP机器人平台(直观外科公司,美国加利福尼亚州森尼韦尔)进行单孔机器人辅助根治性前列腺切除术(SP-RARP)的初步经验。

方法

这项回顾性研究纳入了2020年6月至11月期间由一名外科医生连续进行SP-RARP的30例经前列腺活检确诊为前列腺癌的患者。SP-RARP采用单切口加一法进行,即直接插入多通道引导端口并附加一个辅助端口。我们报告了围手术期和早期功能结果的初步经验。

结果

平均手术时间(标准差)、控制台时间(标准差)和失血量分别为142.8(15.1)分钟、109.9(15.7)分钟和133.0(72.9)毫升。未报告术中并发症或输血情况。30例患者中,分别有21例(70.0%)、7例(23.3%)和2例(6.7%)患有pT2、pT3a和pT3b期疾病。最终病理报告显示,30例患者中有5例(16.7%)手术切缘阳性,包括21例pT2期患者中的2例(9.5%)和9例pT3及以上期患者中的3例(33.3%)。SP-RARP术后12周,80.0%的患者实现了控尿,性功能恢复率为46.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1c/9034298/67e2439f9f28/gr1.jpg

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