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机器人结直肠手术的经验:使用 Senhance 机器人系统的多中心分析的全面见解。

Experiences in robotic colorectal surgery: comprehensive insights from a multi-center analysis using the Senhance Robotic System.

机构信息

Center of General Surgery, Republican Vilnius University Hospital, Vilnius, Lithuania.

Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

J Robot Surg. 2024 Oct 24;18(1):375. doi: 10.1007/s11701-024-02136-w.

Abstract

Robotic-assisted surgery has revolutionised minimally invasive approaches, particularly in colorectal surgery. While many single-center studies on colorectal surgeries exist in present literature, including experiences with Senhance® Robotic Systems, comprehensive multi-center studies are lacking. This study, conducted through the TransEnterix European Patient Registry ("TRUST"), aims to assess the safety and feasibility in this context. The present study explored procedural times, complications, robotic malfunction and limitations, adverse events and pain management outcomes for colorectal procedures, including sigmoid resection, right hemicolectomy and rectal surgery collected in two European centers. Data from 355 colorectal surgeries showed that the median duration of surgery was 147.2 min (IQR: 124.3-183.0), the docking time was reported with a median of 3.4 min (IQR: 2.0-5.4) and the console time was found at a mean of 84.4 min (SD: 33.6). Despite minimal blood loss, pain scores, and robotic malfunction, 2.9% of the cases (10 instances) required conversions to either an open or laparoscopic approach. Further, most robotic limitations were attributed to limited motion (18.9%, 67 cases) and collisions (11.5%, 41 cases). Adverse events (24 cases, 6.8%) were effectively managed, with 23 instances judged completely unrelated to the robotic system. This study underscores the positive outcomes and safety profile of Senhance® Robotic Systems in colorectal surgery, contributing valuable insights for future research and clinical practice.

摘要

机器人辅助手术彻底改变了微创方法,特别是在结直肠手术中。尽管目前的文献中有许多关于结直肠手术的单中心研究,包括使用 Senhance®机器人系统的经验,但缺乏全面的多中心研究。本研究通过 TransEnterix 欧洲患者登记处("TRUST")进行,旨在评估这种情况下的安全性和可行性。本研究探讨了两个欧洲中心收集的结直肠手术的程序时间、并发症、机器人故障和限制、不良事件以及疼痛管理结果,包括乙状结肠切除术、右半结肠切除术和直肠手术。来自 355 例结直肠手术的数据显示,手术的中位数持续时间为 147.2 分钟(IQR:124.3-183.0),对接时间中位数为 3.4 分钟(IQR:2.0-5.4),控制台时间平均为 84.4 分钟(SD:33.6)。尽管出血量少、疼痛评分低且机器人故障少,但仍有 2.9%的病例(10 例)需要转为开放或腹腔镜手术。此外,大多数机器人限制归因于运动受限(18.9%,67 例)和碰撞(11.5%,41 例)。大多数不良事件(24 例,6.8%)得到有效处理,23 例被判断与机器人系统完全无关。本研究强调了 Senhance®机器人系统在结直肠手术中的积极结果和安全性,为未来的研究和临床实践提供了有价值的见解。

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