目的：分析达芬奇机器人手术系统在女性梗阻性生殖道畸形中的临床应用效果。方法：回顾性分析 空军军医大学第一附属医院 2015 年 9 月 ~2019 年 10 月使用达芬奇机器人手术系统完成的梗阻性生殖道畸形手术患 者 7 例的临床资料，统计分析不同生殖道畸形的分类、临床表现、手术方法、术后并发症、月经恢复情况和性生活 满意度等。结果：7 例患者中，宫颈发育异常者 6 例，阴道完全闭锁者 4 例，阴道下段闭锁者 1 例，合并子宫内膜 异位症者 6 例，合并泌尿系统畸形者 1 例。所有患者均保留了有功能子宫，6 例行宫颈成形术，5 例行阴道成形术； 所有患者均恢复规律月经，2 例有性生活者性生活均满意。结论：对于梗阻性生殖道畸形的患者，达芬奇机器人手 术系统能更好地重建生殖道解剖结构，保留有功能子宫。

Objective: To analyze the clinical application effect of Da Vinci robotic surgery system on female obstructive genital tract malformation. Methods: 7 cases of female obstructive genital tract malformation underwent Da Vinci robotic surgery in the First Affiliated Hospital of the Air Force Military Medical University from September 2015 to October 2019 were retrospectively analyzed, including the classification, clinical symptoms, surgical methods, postoperative complications, menstrual recovery and sexual satisfaction. Results: Among the 7 patients, there were 6 cases of abnormal cervical dysplasia, 4 cases of complete vaginal atresia, 1 cases of partial vaginal atresia, 6 cases of endometriosis and 1 case of urinary malformation. All patients perserved a functional uterus. 6 cases of cervicoplasty and 5 cases of vaginoplasty were performed. All patients returned to regular menstruation, and two patients had satisfied sexual lives after surgery. Conclusion: For patients with female obstructive genital tract malformation, the Da Vinci surgical system can better reconstruct the anatomical structure of the reproductive tract and preserve a functional uterus.

收稿日期：2020-07-28  录用日期：2020-10-26 

Received Date: 2020-07-28  Accepted Date: 2020-10-26 

基金项目：国家自然科学基金面上项目《SNAP-23 的 O-GlcNAc 修饰介导的卵巢癌细胞外泌体释放与顺铂耐药的相关性研究》 （81972440） 

Foundation Item: National Natural Science Foundation of China General Projects: the relationship between the release of exosomes mediated by O-GlcNAc modification of SNAP-23 and cisplatin resistance in ovarian cancer(81972440) 

通讯作者：陈必良，Email： cblxjh@fmmu.edu.cn 

Corresponding Author: CHEN Biliang,  Email:  cblxjh@fmmu.edu.cn 

引用格式：李玲霞，陈必良，刘淑娟，等 . 机器人手术系统在女性梗阻性生殖道畸形中的应用 [J]. 机器人外科学杂志，2021，2（2）： 84-90. 

Citation: LI L X, CHEN B L, LIU S J,  et al. Application of robotic surgery system in female obstructive genital tract malformations [J]. Chinese Journal of Robotic Surgery,  2021, 2(2):84-90.

[1] 冷金花 , 郎景和 , 连利娟 , 等 . 阴道闭锁 16 例临床 分析 [J]. 中华妇产科杂志 , 2002, 37(4): 217-219. 

[2] Grimbizis G F, Gordts S, Di Spiezio Sardo A, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies[J]. Hum Reprod, 2013, 28(8): 2032-2044. 

[3] 中华医学会妇产科学分会 . 关于女性生殖器官畸形 统一命名和定义的中国专家共识 [J]. 中国妇产科杂 志 , 2015, 50(9): 648-651. 

[4] 于云杰 , 史惠蓉．青春期子宫内膜异位症合并生殖 道畸形 15 例临床分析 [J]. 中国计划生育和妇产科 , 2017, 9(7): 68-71. 

[5] SONG X C, ZHU L, DING J, et al. Clinical characteristics of congenital cervical atresia and associated endometriosis among 96 patients [J]. Int J Gynaecol Obstet, 2016, 134(3): 252-255. 

[6] Matalliotakis M, Goulielmos G N, Matalliotaki C, et al. Endometriosis in adolescent and young girls: report on a series of 55 cases [J]. Journal of Pediatric and Adolescent Gynecology, 2017, 30(5): 568-570. 

[7] 罗光楠 , 秦成路 . 阴道成形术不同术式的利与弊 [J]. 中国实用妇科与产科杂志 , 2018, 34(4): 387-392． 

[8] 罗光楠 , 潘宏．罗湖术式在阴道闭锁治疗中的应 用及热点问题探讨 [J]. 国际妇产科学杂志 , 2017, 44(3): 245-247. 

[9] ZHANG X, TANG X, DING Y, et al. Management of partial vaginal agenesis according to the WhartonSheares-George technique-a long-term follow-up[J]. J Obstet Gynaecol, 2020, 40(5): 715-717. 

[10] Management of Acute Obstructive Uterovaginal Anomalies: ACOG Committee Opinion Summary, Number 779[J].Obstet Gynecol, 2019, 133(6): 1290- 1291. 

[11] Kristensen S E, Mosgaard B J, Rosendahl M, et al. Robot-assisted surgery in gynecological oncology: current status and controversies on patient benefits, cost and surgeon conditions—a systematic review [J]. Acta Obstet Gynecol Scand, 2017, 96(3): 274-285. 

[12] Gkegkes I D, Iavazzo C, Iatrakis G, et al. Robotic management of endometriosis: discussion of use, criteria and advantages: a Review of the Literature[J]. Acta Medica (Hradec Kralove), 2019, 62(4): 147-149. [13] 王一婷 , 贺豪杰 , 梁华茂 , 等 . 先天性宫颈阴道闭 锁初次手术治疗失败后的再处理 : 附 5 例报告 [J]. 中国微创外科杂志 , 2013, 13(2): 145-148. 

[14] WANG T, ZHOU Y, FU J, et al. Level of depression, anxiety and stress in patients with intrauterine adhesions in Hunan Province, China: A cross-sectional study[J]. PLoS One, 2020, 15(3): e0229832.