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回顾性分析了一系列采用机器人辅助腹腔镜技术(R-TAPP)治疗的腹股沟疝患者。

A retrospective review of a large series of groin hernia patients operated with robotically assisted laparoscopic technique (R-TAPP).

机构信息

Department of Surgery, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.

出版信息

J Robot Surg. 2023 Apr;17(2):653-658. doi: 10.1007/s11701-022-01474-x. Epub 2022 Oct 25.

Abstract

We have reviewed the patient outcome and the feasibility of robotically assisted inguinal hernia repair (R-TAPP) from the first 4-years period after its introduction in our department in a Scandinavian Public Health hospital. A total of 226 hernia repairs were performed in 195 patients (31 bilateral hernias). 160 patients had primary hernias, whereas 35 had recurrent hernias. Of the recurrent hernias, three had recurred twice. The majority of the hernias were in the right groin (53.3%) and the lateral location was the most common (65.0%). The hernia was scrotal in 29 cases. The mean operation time was significantly reduced throughout the observation period for our cohort, i.e. from 81 to 57 min (p < 0.001). The operation time was 27 min faster (mean value) in unilateral vs bilateral hernias and 19 min faster (mean value) in primary vs residual hernias. There were no statistically significant differences in operation time between lateral and medial hernias, and no differences in operation time between the obese and normal-weight cases. We experienced four severe per-operative complications (4/226; 1.8%): two cases of abdominal wall bleeding subsequently undergoing intravascular coiling, one perforation of the urinary bladder and one perforation of small bowel that were both closed by direct suture intraoperatively. There were no conversions to laparoscopy or open procedure. One hernia recurred during the observation period. Our findings suggest that the R-TAPP procedure in a Scandinavian Public Health hospital's surgical department is both safe and feasible.

摘要

我们回顾了在斯堪的纳维亚公共卫生医院的外科部门引入机器人辅助腹股沟疝修补术(R-TAPP)后的头 4 年期间的患者结局和可行性。在 195 名患者中进行了 226 例疝修补术(31 例双侧疝)。160 例患者为原发性疝,35 例为复发性疝。在复发性疝中,有 3 例复发了 2 次。大多数疝位于右侧腹股沟(53.3%),外侧位置最常见(65.0%)。29 例疝位于阴囊。整个观察期内,我们组的手术时间明显缩短,即从 81 分钟降至 57 分钟(p<0.001)。单侧疝比双侧疝手术时间快 27 分钟(平均值),原发性疝比残余疝快 19 分钟(平均值)。外侧疝和内侧疝的手术时间无统计学差异,肥胖和正常体重患者的手术时间也无差异。我们有 4 例严重的术中并发症(4/226;1.8%):2 例腹壁出血随后行血管内线圈栓塞,1 例膀胱穿孔,1 例小肠穿孔,均术中直接缝合。无中转腹腔镜或开放手术。观察期间有 1 例疝复发。我们的研究结果表明,在斯堪的纳维亚公共卫生医院外科部门进行的 R-TAPP 手术既安全又可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1c5/10076378/5f5f1f569885/11701_2022_1474_Fig1_HTML.jpg

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