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使用3毫米双极器械的双极法在Senhance辅助下进行腹腔镜部分膀胱切除术的初步经验。

Initial Experience With Senhance-Assisted Laparoscopic Partial Cystectomy Using the Double Bipolar Method With 3 mm Bipolar Instruments.

作者信息

Kawabata Junya, Kaneko Go, Shirotake Suguru, Matsushita Suguru, Homma Taku, Oyama Masafumi, Koyama Isamu

机构信息

Uro-Oncology, Saitama Medical University International medical center, Hidaka, JPN.

Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, JPN.

出版信息

Cureus. 2024 Nov 20;16(11):e74074. doi: 10.7759/cureus.74074. eCollection 2024 Nov.

Abstract

The Senhance robotic system (Asensus Surgical, Durham, NC, USA) is an innovative platform for minimally invasive surgery. It enables surgeons to perform precise and cost-effective procedures using reusable instruments and has advanced features such as haptic feedback and eye-tracking camera control. Herein, we present the first application of the "double bipolar method" (DBM) in a Senhance-assisted laparoscopic partial cystectomy utilizing 3 mm Maryland bipolar instruments. The DBM technique allows for the simultaneous use of bipolar instruments in both hands, thereby providing exceptional control in tissue dissection and coagulation, which are critical for delicate urologic procedures such as partial cystectomy. We present a case of a 62-year-old female patient who had a 2 cm tumor located at the bladder's dome. Following comprehensive preoperative imaging and cystoscopic evaluation, the tumor was deemed suitable for resection using the Senhance system. The DBM technique enabled the precise and bloodless resection of the bladder wall. Intraoperative evaluation confirmed the complete removal of the tumor and the successful closure of the bladder defect using a barbed suture. The patient had an uncomplicated recovery and was discharged on the eighth postoperative day. The combination of Senhance's advanced features and the DBM technique with 3 mm instruments offers a significant advantage in urologic surgery, providing enhanced precision, cost-efficiency, and improved cosmetic outcomes. The DBM technique in conjunction with the Senhance system represents a promising approach for bladder-sparing surgeries, with the potential for widespread adoption in clinical practice.

摘要

森海思机器人系统(美国北卡罗来纳州达勒姆市的阿森苏斯外科公司)是一种用于微创手术的创新平台。它使外科医生能够使用可重复使用的器械进行精确且经济高效的手术,并具有触觉反馈和眼动追踪摄像头控制等先进功能。在此,我们展示了“双极法”(DBM)在森海思辅助腹腔镜部分膀胱切除术中的首次应用,该手术使用了3毫米的马里兰双极器械。DBM技术允许双手同时使用双极器械,从而在组织解剖和凝血过程中提供出色的控制,这对于诸如部分膀胱切除术等精细的泌尿外科手术至关重要。我们介绍了一名62岁女性患者的病例,其膀胱顶部有一个2厘米的肿瘤。经过全面的术前影像学检查和膀胱镜评估,该肿瘤被认为适合使用森海思系统进行切除。DBM技术实现了膀胱壁的精确无血切除。术中评估证实肿瘤已完全切除,并且使用倒刺缝线成功闭合了膀胱缺损。患者恢复顺利,术后第八天出院。森海思的先进功能与DBM技术以及3毫米器械的结合在泌尿外科手术中具有显著优势,可提高精度、降低成本并改善美容效果。DBM技术与森海思系统相结合代表了一种有前景的膀胱保留手术方法,有可能在临床实践中广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c44/11660189/c172302303e8/cureus-0016-00000074074-i01.jpg

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