Seo Jun-Hyeong, Choi Chel-Hun, Lee Yoo-Young
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Gland Surg. 2024 Jun 30;13(6):864-870. doi: 10.21037/gs-23-533. Epub 2024 Jun 20.
Ovarian cysts, common in women of reproductive age, often require surgical intervention, with minimally invasive laparoscopic surgery becoming the preferred method due to its reduced complications and faster recovery. Despite its benefits, challenges such as instrument collisions and operational difficulties limit the use of single- or two-port approaches. The purpose of this study was to evaluate the feasibility of laparoscopic adnexa surgery using an articulating laparoscopic instrument, which offers flexible and ergonomic movements similar to robotic systems.
This multicenter prospective observational study was conducted in South Korea and Taiwan. The electronic medical records of patients who underwent laparoscopic adnexectomy using the articulating laparoscopic instrument (ArtiSential, LIVSMED Inc., Seongnam-si, South Korea) between October 2022 and September 2023 were analyzed. Data on patient demographics, operative and pathologic data were collected prospectively.
A total of 66 patients underwent laparoscopic adnexal surgery using the articulating instrument. The median age of the patients was 43 (range, 23-76) years, and the median body mass index (BMI) was 22.5 (range, 17.1-43.4) kg/m. Thirty-five (53.0%) patients underwent oophorectomy or salpingectomy, while 31 (47.0%) underwent cystectomy of the ovary or fallopian tube. The final pathology after surgery was benign in 61 patients (92.4%), borderline in 3 patients (4.5%), and malignant in 2 patients (3.0%). During surgery, pelvic adhesions were found in 13 patients (19.7%) and adhesiolysis was performed. The median total operation time was 53.5 (range, 26-174) minutes, and median estimated blood loss (EBL) was 50 (range, 10-200) mL. Median length of hospital stay was 1 (range, 0-3) days. Only two patients experienced a postoperative complication, which was trocar site wound dehiscence in both cases.
The results of this study demonstrated the feasibility of using the articulating laparoscopic instrument during laparoscopic adnexectomy.
卵巢囊肿在育龄女性中很常见，通常需要手术干预，由于其并发症减少且恢复更快，微创腹腔镜手术成为首选方法。尽管有诸多益处，但诸如器械碰撞和操作困难等挑战限制了单孔或两孔手术方法的应用。本研究的目的是评估使用可弯曲腹腔镜器械进行腹腔镜附件手术的可行性，该器械能提供类似于机器人系统的灵活且符合人体工程学的动作。
这项多中心前瞻性观察研究在韩国和台湾进行。分析了2022年10月至2023年9月期间使用可弯曲腹腔镜器械（ArtiSential，韩国城南市LIVSMED公司）进行腹腔镜附件切除术的患者的电子病历。前瞻性收集患者人口统计学、手术和病理数据。
共有66例患者使用可弯曲器械进行了腹腔镜附件手术。患者的中位年龄为43岁（范围23 - 76岁），中位体重指数（BMI）为22.5 kg/m²（范围17.1 - 43.4 kg/m²）。35例（53.0%）患者接受了卵巢切除术或输卵管切除术，31例（47.0%）患者接受了卵巢或输卵管囊肿切除术。术后最终病理结果为良性的有61例患者（92.4%），交界性的有3例患者（4.5%），恶性的有2例患者（3.0%）。手术过程中，13例患者（19.7%）发现盆腔粘连并进行了粘连松解术。中位总手术时间为53.5分钟（范围26 - 174分钟），中位估计失血量（EBL）为50毫升（范围10 - 200毫升）。中位住院时间为1天（范围0 - 3天）。仅2例患者出现术后并发症，均为套管针穿刺部位伤口裂开。
本研究结果证明了在腹腔镜附件切除术中使用可弯曲腹腔镜器械的可行性。
