Dipartimento di Scienze della Salute, Divion of Minimally-invasive and Robotic surgery, ASST Santi Paolo e Carlo, Università degli studi di Milano, Milan, Italy.
Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy.
Langenbecks Arch Surg. 2023 Jul 14;408(1):276. doi: 10.1007/s00423-023-03004-1.
Robotic surgery offers new possibilities in repairing complex hernias with a minimally invasive approach. This study aimed to analyze our preliminary results.
Between November 2015 and February 2020, 150 patients underwent robotic reconstruction for abdominal wall defects (77 primary and 73 incisional). A retrospective analysis of a prospectively maintained database was conducted to evaluate the short-term outcomes.
The mean operative time was 176.9 ± 72.1 min. No conversion to open or laparoscopic approach occurred. The mean hospital length of stay was 2.6 ± 1.6. According to Clavien-Dindo classification, two (grade III) complications following retromuscular mesh placement (1.3%) occurred. One patient (0.7%) required surgical revision due to small bowel occlusion following an intraparietal hernia. The 30-day readmission rate was 0.6%, and the mortality was nihil.
Robotic surgery is valuable for safely completing challenging surgical procedures like complex abdominal wall reconstruction, with low conversion and complication rates. A stepwise approach to the different surgical techniques is essential to optimize the outcomes and maximize the benefits of the robotic approach.
机器人手术为微创方式修复复杂疝提供了新的可能。本研究旨在分析我们的初步结果。
2015 年 11 月至 2020 年 2 月,150 例患者接受了腹壁缺损的机器人重建(77 例原发性,73 例切口)。对前瞻性维护的数据库进行回顾性分析,以评估短期结果。
平均手术时间为 176.9 ± 72.1 分钟。无一例转为开放或腹腔镜手术。平均住院时间为 2.6 ± 1.6 天。根据 Clavien-Dindo 分类,在后腹膜网片放置后发生 2 例(3%)(III 级)并发症。1 例(0.7%)患者因壁内疝导致小肠梗阻需要手术修复。30 天再入院率为 0.6%,死亡率为零。
机器人手术对于安全完成复杂腹壁重建等具有挑战性的手术具有重要价值,其转换率和并发症发生率低。对不同手术技术采用逐步方法对于优化结果和最大限度发挥机器人方法的优势至关重要。