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[评估中国研发的模块化手术机器人系统用于机器人辅助肾盂成形术的可行性和安全性]

[Evaluation of the feasibility and safety of a Chinese developed modular surgical robotic system for robot-assisted pyeloplasty].

作者信息

Liu S, Xu L, Li X, Yang K, Li Z, Zhang Z, Wang X, Fu W X, Li Z, Li X

机构信息

Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.

Nursing Department, Peking University First Hospital, Beijing 100034, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Aug 18;57(4):779-783. doi: 10.19723/j.issn.1671-167X.2025.04.024.

Abstract

OBJECTIVE

To evaluate the technical feasibility and perioperative safety of pyeloplasty assisted by the Carina modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction (UPJO).

METHODS

From November to December 2024, five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the Carina modular laparoscopic surgical system at Peking University First Hospital. Data on patient demographics, intraoperative parameters (including docking time, console time, and estimated blood loss), perioperative outcomes, follow-up results, and surgeons' subjective evaluations of system performance were prospectively collected. Descriptive statistics were used; continuous variables were presented as median (range), and categorical variables as frequency and percentage.

RESULTS

The cohort included four females and one male. All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery. The median age was 32 years (24-37 years), and the median body mass index was 21.6 kg/m (15.8-27.3 kg/m). The median docking time was 8 min (3-12 min), and the median console time was 91 min (71-125 min). Intraoperative blood loss was uniformly 20 mL. The median postoperative drainage duration was 3 d (0-4 d), and the median length of hospital stay was 4 d (4-9 d). No Clavien-Dindo grade Ⅲ or higher complications occurred. All the patients had their double-J stents removed at 2 months postoperatively, and pain in the ipsilateral flank, reported preoperatively by all the five patients, was alleviated. The subjective surgical success rate was 100%. Surgeons reported stable system performance throughout all the procedures, with no instances of mechanical arm interference or visual drift affecting surgical fluency.

CONCLUSION

Preliminary findings indicate that pyeloplasty using the domestically deve-loped Carina modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

摘要

目的

评估Carina模块化腹腔镜手术机器人系统辅助肾盂成形术治疗输尿管肾盂连接部梗阻(UPJO)患者的技术可行性和围手术期安全性。

方法

2024年11月至12月,北京大学第一医院连续5例诊断为UPJO的患者使用Carina模块化腹腔镜手术系统接受机器人辅助肾盂成形术。前瞻性收集患者人口统计学数据、术中参数(包括对接时间、控制台操作时间和估计失血量)、围手术期结局、随访结果以及外科医生对系统性能的主观评价。采用描述性统计;连续变量以中位数(范围)表示,分类变量以频数和百分比表示。

结果

该队列包括4名女性和1名男性。所有患者均成功完成机器人手术,未转为开放手术或传统腹腔镜手术。中位年龄为32岁(24 - 37岁),中位体重指数为21.6 kg/m²(15.8 - 27.3 kg/m²)。中位对接时间为8分钟(3 - 12分钟),中位控制台操作时间为91分钟(71 - 125分钟)。术中失血量均为20毫升。术后中位引流持续时间为3天(0 - 4天),中位住院时间为4天(4 - 9天)。未发生Clavien - DindoⅢ级或更高等级的并发症。所有患者均在术后2个月取出双J支架,术前5例患者均报告的同侧胁腹疼痛得到缓解。主观手术成功率为100%。外科医生报告在所有手术过程中系统性能稳定,没有机械臂干扰或视觉漂移影响手术流畅性的情况。

结论

初步研究结果表明,使用国产Carina模块化腹腔镜机器人系统进行肾盂成形术在技术上是可行的,并且对于治疗UPJO围手术期是安全的。

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Robotic surgery.机器人手术。
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