运用国产单孔机器人手术系统完成腹膜外入路前列腺根治性切除术的初步经验
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南京医科大学第二附属医院

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2021年江苏省卫生健康委科研项目


Primary experience of a domestic single-port robotic surgical system for extraperitoneal radical prostatectomy
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The Second Affiliated Hospital of Nanjing Medical University

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Scientific research project of Jiangsu Provincial Health Commission

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    摘要:

    目的:初步探讨运用国产“术锐”单孔蛇形臂机器人手术系统完成腹膜外入路单孔前列腺切除术的手术经验。方法:2021年11月~2022年7月,按照纳排标准收治因前列腺癌拟行前列腺根治性切除术的9例患者,运用国产“术锐”单孔蛇形臂机器人手术系统完成单孔肾上腺切除术,手术均采用经腹膜外入路,记录切口大小、手术时间、操作时间、术中出血量等信息,并对围手术期资料、手术并发症以及术后恢复情况进行分析。结果:9例患者平均年龄74.11岁(66~85岁);平均BMI值23.62(18.3~29.4);平均手术时间168.0min(125~249min);平均操作时间119.2min(85~194min),平均备机时间12.4min(5~36min),无1例增加辅助通道,切口大小平均4.22cm(3.5~5cm);术后平均住院天数19d(12~26d),术后即刻尿控3例,术后1月复查6例患者尿控基本恢复。术后病理均为前列腺腺癌,其中切缘阳性2例。术后均未出现出血、发热、切口感染等并发症。结论:运用“术锐”单孔蛇形臂机器人手术系统可安全、有效地完成腹膜外入路单孔前列腺根治性切除术,蛇形臂具有动作灵活、指向性准确等优势,可保障手术的顺利实施。

    Abstract:

    Objective: To explore the surgical experience of a domestic single-port robotic surgical system in extraperitoneal radical prostatectomy. Methods: From November 2021 to July 2022, 9 patients with prostate cancer were scheduled for radical prostatectomy according to the criteria of the nanorobot. A domestic single-port robotic surgical system was used to complete radical prostatectomy using a transperitoneal approach. Information on incision size, operative time, operating time, and intraoperative blood loss was recorded. Besides, perioperative data, surgical complications and postoperative recovery were also analyzed. Results: The mean age of the 9 patients was 74.11 years (range: 66 to 85 years), mean BMI value of 23.62 (18.3 to 29.4), mean operative time of 168.0 min (125 to 249 min), mean operation time of 119.2 min (85 ~ 194min), mean preparation time of 12.4min (5 ~ 36min), and the mean incision size of 4.22cm (3.5 ~ 5cm). While, no cases had added auxiliary channels. The average postoperative hospital stay was 19 days (range: 12 to 26 days). For urinary control, 3 patients was restored immediately after surgery and 6 patients restored in one month after surgery. All the patients were pathologically confirmed as prostatic adenocarcinoma, among which 2 cases were found with positive margins. No complications such as bleeding, fever, and incision infection was found in patients in the postoperative period. Conclusion: Using the domestic single-port robotic surgical system could safely and effectively complete single-port extraperitoneal radical prostatectomy. In addition, the serpentine arm had the advantages of flexible movement and accurate pointing, which can guarantee the smooth implementation of surgery.

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  • 收稿日期:2022-09-29
  • 最后修改日期:2022-12-03
  • 录用日期:2023-08-09
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