Department of Surgery, Saga University Faculty of Medicine, Saga, Japan.
Department of Surgery, Saga University Faculty of Medicine, Saga, Japan.
Surg Oncol. 2023 Oct;50:101974. doi: 10.1016/j.suronc.2023.101974. Epub 2023 Jul 11.
Although robotic surgery has rapidly spread in pancreatectomy [1], the procedure is performed by the da Vinci™ Surgical System (Intuitive Surgical Inc., CA), the most common surgical robot in the world [2]. We herein present our first experience of robotic distal pancreatectomy using a new Japanese surgical robot named the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan).
A 68-year-old man who was found to have the mass lesion in the pancreatic tail in a medical examination. Investigations, including various imaging studies suggested a diagnosis of pancreatic cancer (Fig. 1). The patient was considered for robotic pancreatectomy.
Five trocars, including one port for the assistant surgeon, were placed at the upper abdomen. The operation unit was rolled in from the right side (Fig. 2). The patient successfully underwent robotic distal pancreatectomy combined with dissection of the regional lymph nodes using the hinotori™ system. The cockpit surgeon performed all procedures, excluding port placement, vessel clipping, and transection of the pancreas. There were no unrecoverable device errors in this operation. The total operation time was 473 minutes, and the estimated blood loss was 182 ml. The postoperative course was uneventful, and hospital length of stay was 10 days. Pathological diagnosis was pancreatic cancer, T1N1M0, Stage ⅡB. Adjuvant chemotherapy using S-1 was administered, and he has survived without recurrence for 3 months after the curative resection.
This is the first report of robotic pancreatectomy using the hinotori™ system, which showed the favorable perioperative results. The accumulation of experience and further studies are required to confirm its clinical benefits.
尽管机器人手术在胰脏切除术[1]中迅速普及，但该手术是由达芬奇™手术系统（直觉外科公司，加利福尼亚州）完成的，达芬奇™手术系统是世界上最常见的手术机器人[2]。在此，我们报告首例使用新型日本手术机器人hinotori™手术机器人系统（兵库，日本Medicaroid 公司）进行的机器人胰脏远端切除术的经验。
一名 68 岁男性在体检中发现胰尾有肿块病变。包括各种影像学研究在内的检查提示胰腺恶性肿瘤（图 1）。该患者被考虑行机器人胰脏切除术。
在上腹部放置了 5 个套管，包括一个助手外科医生的端口。手术单元从右侧滚动进来（图 2）。患者成功地接受了机器人胰脏远端切除术，并使用 hinotori™系统进行了区域淋巴结的解剖。驾驶舱外科医生进行了所有操作，除了套管放置、血管夹闭和胰腺切断。该手术中没有无法恢复的设备故障。总手术时间为 473 分钟，估计失血量为 182ml。术后过程平稳，住院时间为 10 天。病理诊断为胰腺恶性肿瘤，T1N1M0，ⅡB 期。行 S-1 辅助化疗，根治性切除术后 3 个月患者无复发且存活。
这是首例使用 hinotori™系统进行机器人胰脏切除术的报告，显示了良好的围手术期结果。需要积累经验并进一步研究，以确认其临床获益。
