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单孔机器人手术“工具箱”:初学者入门指南。

The single port robotic surgical "toolbox": a primer for beginners.

机构信息

Department of Urology, Rush University, Chicago, IL, USA.

Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.

出版信息

Minerva Urol Nephrol. 2024 Oct;76(5):635-639. doi: 10.23736/S2724-6051.24.05766-5.

Abstract

BACKGROUND

The aim of this study is to provide a comprehensive overview of the da Vinci Single Port robotic platform, including instruments and tools that can aid in implementing the use of this novel platform.

METHODS

Footage recorded during various Single port robotic urologic procedures and dry labs performed at two US institutions was used as video material. A step-by-step guide illustrating key points on OR set-up, platform, instruments, trocar configurations, intraoperative suctioning, bedside assistance were discussed and highlighted.

RESULTS

The Single port surgeon console resembles the Xi console but includes upgraded software. The 6-mm biarticulated instruments incorporate an elbow and a wrist flexible joint. These instruments are deployed through the Access port. Access port kit includes the Access port, and a 25-mm multichannel trocar accommodating an 8-mm flexible scope, and three 6-mm robotic instruments. The 0° endoscope has two sets of articulation: a fixed one, and a distal one, allowing for three movements, selected with a hand command, the "Camera Adjust", the "Camera Control" and the "Relocation." The "Cobra mode," is an extra setting that allows the camera to wing out and move laterally relative to the working instruments. Suction is preferably performed with the Remotely Operated Suction Irrigation system.

CONCLUSIONS

Herein we provide a detailed guide to the main technical nuances of the Single port platform and a practical overview of the instrumentation that is used during Single port robotic procedures. Knowledge of the toolbox that is used during Single port robotic surgery is key for those approaching for the first time this novel technology.

摘要

背景

本研究旨在全面概述达芬奇单端口机器人平台,包括可用于实施该新型平台的仪器和工具。

方法

使用在美国两个机构进行的各种单端口机器人泌尿科手术和干实验室录制的视频资料作为视频材料。逐步演示了手术室设置、平台、仪器、套管配置、术中抽吸、床边协助等方面的关键要点。

结果

单端口外科医生控制台类似于 Xi 控制台,但包含升级的软件。6 毫米的双关节器械具有肘部和手腕灵活关节。这些器械通过接入端口部署。接入端口套件包括接入端口、一个 25 毫米多通道套管,可容纳 8 毫米柔性镜和三个 6 毫米机器人器械。0°内窥镜有两组关节:一组固定,一组远端,可通过手部指令选择三个运动,分别是“Camera Adjust”、“Camera Control”和“Relocation”。“Cobra mode”是一个额外的设置,允许摄像头相对于工作器械向外摆动和横向移动。抽吸最好使用远程操作抽吸冲洗系统进行。

结论

本文提供了单端口平台主要技术细节的详细指南,并对单端口机器人手术中使用的仪器进行了实用概述。对于首次接触这种新型技术的人来说,了解单端口机器人手术中使用的工具包是关键。

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