目的：探讨 6 种自制体位摆放用具的制作方法及其在泌尿外科机器人手术中的应用效果。方法：选 取 2021 年 4 月—2022 年 2 月于聊城市人民医院行泌尿外科机器人手术患者 69 例，其中 32 例患者取头低仰卧分腿 位并使用自制颈肩约束带代替肩档，自制棉腿套及多功能约束带分别固定下肢与床板；37 例患者侧卧位采用自制肩 垫抬高肩峰与健侧腰部，棉腿套包裹下肢且用体位垫支托，多功能约束带及双条宽胶布代替侧卧位档固定患者。观 察患者术中体位稳定性、术野暴露情况、手术时长、机械臂接机时长、体位持续时长、患者术后皮肤状况及有无体 位并发症发生。结果：69 例患者术中体位稳定，术野暴露充分，20 例机器人辅助腹腔镜前列腺癌根治术（Robot-assisted Laparoscopic Radical Prostatectomy，RALRP）患者手术时长为 132~215min，机械臂接机时长为 92~173min，头低仰卧 位时长为 102~185min；12 例机器人辅助腹腔镜膀胱全切术（Robot-assisted Laparoscopic Total Cystectomy，RALTC） 患者手术时长为 245~375min，机械臂接机时长为 155~208min，头低仰卧位时长为 192~295min；37 例机器人辅助腹 腔镜肾部分切除术（Robot-assisted Laparoscopic Partial Nephrectomy，RALPN）患者手术时长为 105~173min，机械臂 接机时长为 65~145min，侧卧位时长为 115~180min。患者术后皮肤完整，术毕 72h 回访无肢体疼痛、下肢深静脉血 栓形成及神经损伤等并发症的发生。结论：在摆放泌尿外科机器人手术体位时，6 种自制体位摆放用具不仅能使患 者身体舒适，减少体位并发症的发生，而且也能方便术者操作及机械臂的灵活摆动，并节约护理成本，自制体位摆 放用具方便清洗灭菌和擦拭消毒，也符合手术室消毒隔离原则。

Objective: To introduce the application effect of six self-made positioning devices in robotic urologic surgery. Methods: From April 2021 to February 2022, 69 cases of robotic urologic surgeries in Liaocheng People’s Hospital were selected. Self-made neck and shoulder restraint belts were used to replace shoulder gear in 32 cases under Trendelenburg position, self-made cotton leg sleeves and multi-functional restraint belts were used to fix lower limbs and bed plate respectively. 37 cases in lateral position, self-made shoulder pads were used to raise the acromion and the healthy side of waist, cotton leg sleeves were used to wrap the lower limbs and positioning pads to support the patients. Multifunctional restraint belt and double sided sticky tape were used to fix patients in lateral position. The intraoperative postural stability, exposure of operative field, operative time, mechanical arm docking time, posture duration, postoperative skin condition and complications of patient positioning were observed. Results: Positions of 69 patients were all stable and the operative field was fully exposed. The operative time of 20 patients under Robot-assisted Laparoscopic Radical Prostatectomy (RALRP) was (132 to 215)min, with the mechanical arm docking time of (92 to 173)min, and the time of Trendelenburg position of (102 to 185)min. The operative time of 12 patients under Robot-assisted Laparoscopic Total Cystectomy (RALTC) was (245 to 375) min, with the time of mechanical arm docking of (155 to 208) min, and the time of Trendelenburg position of (192 to 295) min. The operative time of 37 patients under Robot-assisted Laparoscopic Partial Nephrectomy (PALPN) was (105 to 173)min, with the mechanical arm docking time of (65 to 145)min, and the lateral position time of (115 to 180)min. Patients’ skin was intact after operation. There were no complications such as limb pain, lower extremity deep venous thrombosis or nerve injury after 72 hours of follow-up. Conclusion: Six self-made positioning devices could not only make patients comfortable and reduce positioning complications in robotic urologic surgery, but also facilitate surgeons to operate mechanical arms flexibly, as well as saving nursing care cost. Meanwhile, self-made positioning devices are easy-cleaning, sterilizing and disinfecting, which is worthy of promotion in the operating room with robotic surgical system.

收稿日期：2022-03-28  录用日期：2022-10-11 

Received Date: 2022-03-28 Accepted Date: 2022-10-11 

基金项目：济宁医学院 2022 年度实践教学教育研究计划项目（JYSJ2022B12） 

Foundation Item: Practical Teaching Education Research Project of Jining Medical College in 2022 (JYSJ2022B12) 

通讯作者：陈雪莉，Email：shirley0635@126.com 

Corresponding Author: CHEN Xueli, Email: shirley0635@126.com 

引用格式：陈雪莉，马建中，崔福荣 . 六种自制体位摆放用具在泌尿外科机器人手术中的应用 [J]. 机器人外科学杂志（中英文），2023，4（3）：220-226. 

Citation: CHEN X L, MA J Z, CUI F R. Application of six self-made positioning devices in robotic urological surgery[J]. Chinese Journal of Robotic Surgery, 2023, 4(3): 220-226.

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