Kakibuchi Akiyo, Ito Fumitake, Kokabu Tetsuya, Okimura Hiroyuki, Takaoka Osamu, Mori Taisuke
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Int J Surg Case Rep. 2022 Aug;97:107473. doi: 10.1016/j.ijscr.2022.107473. Epub 2022 Aug 3.
Compared to conventional laparoscopic surgery, robot-assisted surgery enables precise operation, with the aid of high-resolution 3D images and articulated forceps, even in cases where the uterus is very large.
A 48-year-old woman with severe obesity was referred to our hospital with atypical genital bleeding for half a year. She was diagnosed with multiple uterine leiomyomas and early endometrial cancer with presumed advanced stage classification (stage IA). Robot-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node biopsy were performed. Due to the difficulty of removing the uterus transvaginally, the umbilical incision was extended by 7 cm, which allowed the uterine tissue removal without shredding or leakage into the pelvic cavity. The patient was discharged 5 days postoperatively, with no postoperative complications.
Robot-assisted surgery has often been used for the management of early-stage endometrial cancer. Robot-assisted laparoscopic hysterectomy has significantly fewer intraoperative and postoperative complications than laparoscopic and abdominal hysterectomy.
Improving this surgical procedure allows for safe and easy robot-assisted uterine malignant tumor removal even in cases where the patient presents with severe obesity and huge uterine leiomyomas.
与传统腹腔镜手术相比，机器人辅助手术借助高分辨率3D图像和关节式钳，即便子宫非常大的情况下也能实现精确操作。
一名48岁重度肥胖女性因非典型生殖器出血半年转诊至我院。她被诊断为多发性子宫平滑肌瘤和早期子宫内膜癌，推测为晚期分类（IA期）。实施了机器人辅助腹腔镜子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结活检。由于经阴道切除子宫困难，脐部切口延长7厘米，从而能够完整取出子宫组织而无撕裂或漏入盆腔。患者术后5天出院，无术后并发症。
机器人辅助手术常用于早期子宫内膜癌的治疗。机器人辅助腹腔镜子宫切除术的术中和术后并发症明显少于腹腔镜和开腹子宫切除术。
改进该手术方法，即使患者存在重度肥胖和巨大子宫平滑肌瘤，也能安全、轻松地通过机器人辅助切除子宫恶性肿瘤。
