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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.

DOI:10.1007/s11701-024-02136-w
PMID:39443387
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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J Robot Surg. 2024 Oct 24;18(1):375. doi: 10.1007/s11701-024-02136-w.
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本文引用的文献

1
First clinical experience using augmented intelligence in robotic colorectal surgery with the Senhance robotic platform.在使用Senhance机器人平台进行机器人结直肠手术中运用增强智能的首次临床经验。
Ann Coloproctol. 2024 Aug;40(4):412-414. doi: 10.3393/ac.2023.00815.0116. Epub 2024 Aug 30.
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Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers.机器人手术的进展:当前应用及未来前沿的全面概述。
Cureus. 2023 Dec 12;15(12):e50415. doi: 10.7759/cureus.50415. eCollection 2023 Dec.
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Early experiences in robotic single-site plus one port platform for complex hepatobiliary and pancreatic surgery.
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Long-term outcomes and cost-effectiveness evaluation of robot-assisted stereotactic hematoma drainage for spontaneous intracerebral hemorrhage.机器人辅助立体定向血肿引流术治疗自发性脑出血的长期疗效及成本效益评估
Front Neurol. 2023 Nov 24;14:1291634. doi: 10.3389/fneur.2023.1291634. eCollection 2023.
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Learning curves and procedural times in Senhance®-robotic assisted fundoplication: results from 237 consecutive patients undergoing robotic fundoplication in a single center as part of the European TRUST Robotic Surgery Registry Study.在 Senhance®机器人辅助胃底折叠术中的学习曲线和手术时间:作为欧洲 TRUST 机器人手术注册研究的一部分,在单一中心对 237 例连续接受机器人胃底折叠术的患者的结果。
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6
Perioperative outcomes of robotic and laparoscopic surgery for colorectal cancer: a propensity score-matched analysis.机器人与腹腔镜手术治疗结直肠癌的围手术期结局:倾向评分匹配分析。
World J Surg Oncol. 2023 Aug 30;21(1):272. doi: 10.1186/s12957-023-03138-y.
7
Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases.达芬奇 SP®手术系统单孔机器人结直肠手术:50 例初步结果。
Tech Coloproctol. 2023 Jul;27(7):589-599. doi: 10.1007/s10151-023-02791-5. Epub 2023 Mar 27.
8
Sigmoid colon resection for sigmoid cancer using a Senhance robotic system and indocyanine green fluorescent angiography-a video correspondence.使用森海斯机器人系统和吲哚菁绿荧光血管造影术进行乙状结肠癌乙状结肠切除术——视频通信
Colorectal Dis. 2023 May;25(5):1062-1063. doi: 10.1111/codi.16453. Epub 2023 Jan 11.
9
The Senhance Surgical System in Colorectal Surgery: A Systematic Review.《结直肠外科中的 Senhance 手术系统:系统评价》。
J Robot Surg. 2023 Apr;17(2):325-334. doi: 10.1007/s11701-022-01455-0. Epub 2022 Sep 21.
10
Short-term results of robot-assisted colorectal cancer surgery using Senhance Digital Laparoscopy System.使用 Senhance 数字腹腔镜系统的机器人辅助结直肠癌手术的短期结果。
Asian J Endosc Surg. 2022 Jul;15(3):613-618. doi: 10.1111/ases.13064. Epub 2022 Apr 28.