Kim Byung-Chang, Kwon Douk, Pak Shin Jeong, Cho Jae Won, Kim Won Woong, Sung Tae-Yon, Chung Ki-Wook, Lee Yu-Mi
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Olympic-Ro 43-Gil 88, Songpa-Gu, Seoul, 05505, Republic of Korea.
Surg Endosc. 2023 Nov;37(11):8269-8276. doi: 10.1007/s00464-023-10380-8. Epub 2023 Sep 6.
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.
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。
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