Noh Joseph J, Jeon Jung-Eun, Jung Ji-Hee, Kim Tae-Joong
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
J Pers Med. 2023 Jul 24;13(7):1178. doi: 10.3390/jpm13071178.
We compared surgical outcomes between single-port access total laparoscopic hysterectomy (SPA-TLH) and hybrid robotic single-site hysterectomy (RSSH), a new technique of combining the benefits of SPA-TLH with RSSH in this study. A total of 64 patients were retrospectively analyzed. They underwent either hybrid RSSH or SPA-TLH for benign gynecologic disease between December 2018 and August 2021. To assess the feasibility of hybrid RSSH, the clinical characteristics and surgical outcomes were compared between the hybrid RSSH group (n = 29) and the SPA-TLH group (n = 35). All of the surgeries were completed without requiring additional ports or conversion to laparotomy. The surgical outcomes including total operative time, uterine weight, estimated blood loss, hemoglobin changes, length of hospital stay, and postoperative pain scores were not significantly different between the two groups. The colpotomy time, including the detachment of the uterosacral and cardinal ligaments, was shorter in the hybrid RSSH group than in the SPA-TLH group (8.0 min vs. 14.0 min; = 0.029). However, the vaginal cuff closure time was longer in the hybrid RSSH group than in the SPA-TLH group (15.0 min vs.10.0 min; = 0.001). No difference was observed with regards to intraoperative and postoperative complications. Hybrid RSSH appears to be a feasible procedure for hysterectomy in patients with benign gynecologic diseases.
在本研究中,我们比较了单孔腹腔镜全子宫切除术(SPA-TLH)与混合机器人单部位子宫切除术(RSSH,一种结合了SPA-TLH和RSSH优点的新技术)的手术效果。对64例患者进行了回顾性分析。2018年12月至2021年8月期间,她们因良性妇科疾病接受了混合RSSH或SPA-TLH手术。为评估混合RSSH的可行性,比较了混合RSSH组(n = 29)和SPA-TLH组(n = 35)的临床特征和手术效果。所有手术均无需额外打孔或转为开腹手术即可完成。两组的手术效果,包括总手术时间、子宫重量、估计失血量、血红蛋白变化、住院时间和术后疼痛评分,差异均无统计学意义。混合RSSH组的阴道断端缝合时间,包括子宫骶韧带和主韧带的离断时间,比SPA-TLH组短(8.0分钟对14.0分钟;P = 0.029)。然而,混合RSSH组的阴道断端关闭时间比SPA-TLH组长(15.0分钟对10.0分钟;P = 0.001)。术中及术后并发症方面未观察到差异。混合RSSH似乎是治疗良性妇科疾病患者子宫切除术的一种可行术式。