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使用达芬奇SP机器人系统行后腹腔镜肾上腺切除术单孔手术的安全性和可行性:一项回顾性队列研究

Safety and feasibility of single-port surgery for posterior retroperitoneal adrenalectomy using the da Vinci SP robotic system: a retrospective cohort study.

作者信息

Kim Byung-Chang, Kwon Douk, Pak Shin Jeong, Cho Jae Won, Kim Won Woong, Sung Tae-Yon, Chung Ki-Wook, Lee Yu-Mi

机构信息

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil 88, Songpa-Gu, Seoul, 05505, Republic of Korea.

出版信息

Surg Endosc. 2023 Nov;37(11):8269-8276. doi: 10.1007/s00464-023-10380-8. Epub 2023 Sep 6.


DOI:10.1007/s00464-023-10380-8
PMID:37672110
Abstract

BACKGROUND: This study demonstrates our experience of single-port robotic posterior retroperitoneal adrenalectomy (RPRA) using the da Vinci SP robot system and evaluates its technical feasibility and surgical outcomes. METHODS: We conducted a retrospective analysis of 250 RPRAs, including 117 conventional 3-port RPRAs, 103 reduced 2-port RPRAs, and 30 single-port RPRAs. Each RPRA type was compared by analyzing 30 patients in the early phase of surgery. RESULTS: All patients who underwent single-port RPRA showed excellent surgical outcomes. Age, sex, BMI, and tumor location site did not significantly differ between the three groups. In the early phase, the size of the adrenal tumor was similar between three groups, and it tended to increase as the number of ports increased (p < 0.001). The mean operation time was shorter for patients who underwent single-port RPRA than those who underwent RPRA types (p < 0.001). The numeric rating scale score did not significantly differ between the groups on most days. No major complications were observed, and no patients were converted to open surgery or required additional port insertion. CONCLUSION: Single-port RPA using the da Vinci SP robotic system showed the effectiveness of the surgical procedure and improved cosmetic outcomes for patients, while also enabling surgeons to perform operations with greater ease and convenience. Therefore, single-port RPRA could be a good alternative option for the treatment of adrenal tumors in selected situations.

摘要

背景:本研究展示了我们使用达芬奇SP机器人系统进行单孔机器人后腹腔镜肾上腺切除术(RPRA)的经验,并评估其技术可行性和手术效果。 方法:我们对250例RPRA进行了回顾性分析,包括117例传统三孔RPRA、103例简化两孔RPRA和30例单孔RPRA。通过分析每组手术早期的30例患者来比较每种RPRA类型。 结果:所有接受单孔RPRA的患者均显示出良好的手术效果。三组患者的年龄、性别、体重指数和肿瘤位置无显著差异。在早期,三组肾上腺肿瘤大小相似,且随着孔数增加有增大趋势(p < 0.001)。接受单孔RPRA的患者平均手术时间短于接受其他类型RPRA的患者(p < 0.001)。在大多数日子里,数字评分量表得分在各组之间无显著差异。未观察到重大并发症,也没有患者转为开放手术或需要额外插入端口。 结论:使用达芬奇SP机器人系统的单孔RPA显示了手术的有效性,并改善了患者的美容效果,同时也使外科医生能够更轻松方便地进行手术。因此,在某些情况下,单孔RPRA可能是治疗肾上腺肿瘤的一个良好替代选择。

相似文献

[1]
Safety and feasibility of single-port surgery for posterior retroperitoneal adrenalectomy using the da Vinci SP robotic system: a retrospective cohort study.

Surg Endosc. 2023-11

[2]
Safety and feasibility of reduced-port site surgery for robotic posterior retroperitoneal adrenalectomy.

Surg Endosc. 2020-10

[3]
Robot-assisted posterior retroperitoneoscopic adrenalectomy using single-port access: technical feasibility and preliminary results.

Ann Surg Oncol. 2013-3-14

[4]
Robotic Adrenalectomy Using the da Vinci SP Robotic System: Technical Feasibility Comparison with Single-Port Access Using the da Vinci Multi-arm Robotic System.

Ann Surg Oncol. 2022-5

[5]
Exploring the Benefits of a Reduced-Port Approach in Robotic Posterior Retroperitoneoscopic Adrenalectomy: A Comparative Study of the Two-Port and Three-Port Techniques.

J Laparoendosc Adv Surg Tech A. 2024-2

[6]
Single-port robotic-assisted adrenalectomy: feasibility, safety, and cost-effectiveness.

JSLS. 2015

[7]
Robot-assisted laparoendoscopic single site adrenalectomy: A comparison of 3 different port platforms with 3 case reports.

Medicine (Baltimore). 2017-12

[8]
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JSLS. 2022

[9]
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[10]
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引用本文的文献

[1]
The current landscape of single-port robotic surgery in urology.

Nat Rev Urol. 2025-9-2

[2]
Comparison of da Vinci SP and Xi surgical systems for robotic lateral transperitoneal adrenalectomy: a retrospective single-center observational study.

Ann Surg Treat Res. 2025-6

[3]
Adrenalectomy Performed with the Da Vinci Single-Port Robotic System: A Systematic Review and Pooled Analysis.

Cancers (Basel). 2025-4-20

[4]
Single-Port Robotic Posterior Retroperitoneoscopic Adrenalectomy: Current Perspectives, Technical Considerations, and Future Directions.

J Clin Med. 2025-3-28

本文引用的文献

[1]
Robotic Adrenalectomy Using the da Vinci SP Robotic System: Technical Feasibility Comparison with Single-Port Access Using the da Vinci Multi-arm Robotic System.

Ann Surg Oncol. 2022-5

[2]
Longitudinal analysis of retroperitoneoscopic adrenalectomy regarding cosmesis outcomes: comparison of lateral transperitoneal and reduced port laparoscopic adrenalectomy.

Updates Surg. 2022-4

[3]
Safety and feasibility of reduced-port site surgery for robotic posterior retroperitoneal adrenalectomy.

Surg Endosc. 2020-10

[4]
Robotic-assisted adrenalectomy using da Vinci Xi vs. Si: are there differences?

J Robot Surg. 2019-7-4

[5]
Laparoendoscopic Single-site Adrenalectomy versus Conventional Laparoscopic Adrenalectomy: An Updated Meta Analysis.

Urol J. 2016-4-16

[6]
Surgical results of reduced port laparoscopic adrenalectomy using a multichannel port in comparison with conventional laparoscopic adrenalectomy.

Asian J Surg. 2017-1

[7]
Systematic Review of Surgical Approaches for Adrenal Tumors: Lateral Transperitoneal versus Posterior Retroperitoneal and Laparoscopic versus Robotic Adrenalectomy.

Int J Endocrinol. 2014-12-17

[8]
Laparoscopic bilateral transperitoneal adrenalectomy for Cushing syndrome: surgical challenges and lessons learnt.

Surg Laparosc Endosc Percutan Tech. 2013-6

[9]
Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic surgery: a systematic review and meta-analysis of observational studies.

J Endourol. 2013-4-23

[10]
Robot-assisted posterior retroperitoneoscopic adrenalectomy using single-port access: technical feasibility and preliminary results.

Ann Surg Oncol. 2013-3-14

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