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手术机器人辅助经肛门标本取出的无辅助腹部切口乙状结肠癌根治术

Surgical Robot-assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision.

作者信息

Wang Chunlin, Wang Yuliuming, Liu Yunxiao, Zhang Hao, Zhang Xin, Yang Yihaoran, Wang Xin, Hu Hanqing, Jin Yinghu, Wang Guiyu

机构信息

Department of Colorectal Cancer Surgery, The Second Affiliated Hospital of Harbin Medical University.

Department of Colorectal Cancer Surgery, The Second Affiliated Hospital of Harbin Medical University;

出版信息

J Vis Exp. 2025 Jun 13(220). doi: 10.3791/67857.

Abstract

Robot-assisted natural orifice specimen extraction surgery (NOSES) for sigmoid colon cancer represents an innovative, minimally invasive surgical technique that integrates the benefits of minimally invasive surgery with natural orifice specimen extraction. In this study, a 67-year-old male patient diagnosed with sigmoid colon cancer underwent Kangduo surgical robot-assisted NOSES, with a total operative time of 290 min and an estimated intraoperative blood loss of 50 mL. The procedure involved robotic-assisted radical resection of the sigmoid colon, regional lymphadenectomy, and specimen extraction through a natural orifice. Postoperative histopathological analysis confirmed the absence of residual malignancy in the resected sigmoid colon, while 12 pericolic lymph nodes exhibited reactive hyperplasia. Both the proximal and distal surgical margins were negative for malignancy. The patient had an uneventful recovery and was discharged on postoperative day 7. The precision and flexibility of the robotic system facilitated NOSES by minimizing abdominal wall trauma, reducing postoperative complications, and shortening recovery time. This finding indicates that robot-assisted NOSES is a safe and feasible approach for the surgical treatment of sigmoid colon cancer, though further clinical experience and long-term follow-up are required to comprehensively assess its efficacy.

摘要

机器人辅助经自然腔道标本取出手术(NOSES)治疗乙状结肠癌是一种创新的微创手术技术,它融合了微创手术与经自然腔道标本取出的优点。在本研究中,一名67岁的男性乙状结肠癌患者接受了康多手术机器人辅助的NOSES手术,总手术时间为290分钟,估计术中出血量为50毫升。该手术包括机器人辅助的乙状结肠根治性切除术、区域淋巴结清扫术以及经自然腔道取出标本。术后组织病理学分析证实,切除的乙状结肠无残留恶性肿瘤,而12个结肠旁淋巴结表现为反应性增生。手术切缘的近端和远端均无恶性肿瘤。患者恢复顺利,术后第7天出院。机器人系统的精确性和灵活性通过减少腹壁创伤、降低术后并发症以及缩短恢复时间,为NOSES手术提供了便利。这一发现表明,机器人辅助NOSES是治疗乙状结肠癌的一种安全可行的手术方法,不过需要进一步的临床经验和长期随访来全面评估其疗效。

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