中国的机器人外科学杂志 | ISSN 2096-7721 | CN 10-1650/R

运用国产单孔机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经验(附视频)

Primary experience of a domestic single-port robotic surgical system in retroperitoneal adrenalectomy (with video)

作者:魏勇,沈露明,沈百欣,胡海斌,刘威,杨健,蒋荣江,朱清毅

Vol. 5 No. 1 Feb. 2024 DOI: 10.12180/j.issn.2096-7721.2024.01.003 发布日期:2024-03-06
关键词:单孔机器人手术系统;腹膜后入路;肾上腺切除术

作者简介:

目的:探讨运用国产“术锐”单孔蛇形臂机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经 验。方法:南京医科大学第二附属医院泌尿外科于 2021 年 11 月—2021 年 12 月收治的 4 例肾上腺肿瘤患者,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,手术均采用经腹膜后入路,记录肿瘤大小、手术时间、 术中出血量等信息,并对围手术期资料、手术并发症及术后恢复情况进行分析。结果:4 例患者中男女各 2 例,年龄 40~68 岁,平均年龄 54 岁,平均 BMI 值为 26.2(24.8~29.8)kg/m2 ;肿瘤最大直径 1.2~3.3 cm,其中左侧 1 例,右侧 3 例;4 例手术均采用纯单孔方式,术中均未增加辅助通道,手术总时间 104~200 min,机器人操作时间 50~96 min, 术中出血量 10~50 ml。术后病理诊断为肾上腺皮质腺瘤 3 例,右血管内乳头状内皮细胞增生(Masson 瘤)1 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 腹膜后入路单孔肾上腺切除术,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。

Objective: To explore the surgical experience of domestic single-port robotic surgical system (Single-port surgical robot with sneak-like arms, Beijing Surgerii Robotics Co., Ltd) in retroperitoneal adrenalectomy. Methods: 4 patients who were scheduled for adrenalectomy due to adrenal neoplasm in the Department of Urology of the Second Affiliated Hospital of Nanjing Medical University from Nov. 2021 to Dec. 2021 were selected as the research objects. Domestic singleport robotic surgical system was used to perform single-port adrenalectomy on the 4 patients with retroperitoneal approach. Clinical data on tumor size, operative time, intraoperative blood loss was recorded, and perioperative data, surgical complications and postoperative recovery were analyzed. Results: 4 patients (2 male and 2 female) with a mean age of 54 years (40 to 68 years) and a mean BMI of 26.2 (24.8 to 29.8) kg/m2 . The tumors ranged from 1.2 to 3.3 cm in maximum diameter, including 1 case of left side and 3 cases of right side. The 4 cases of surgeries were all performed under single-port without extra auxiliary channels, and the total operative time ranged from 104 to 200 min, while the robotic operative time ranged from 50 to 96 min, with the intraoperative blood loss of 10 to 50 ml. Adrenocortical adenoma was confirmed in 3 patients and papillary endothelial cell hyperplasia (Masson’s tumor) within the right vessel in 1 patient by postoperative pathological diagnosis. There were no complications such as bleeding, fever, and incision infection found in the postoperative period. Conclusion: With the advantages of flexible movement and accurate operation of serpentine arms, retroperitoneal adrenalectomy could be safely and effectively performed with the domestic single-port robotic surgical system.

稿件信息

收稿日期:2022-07-12  录用日期:2023-08-22 

Received Date: 2022-07-12  Accepted Date: 2023-08-22 

基金项目:江苏省卫生健康委科研项目(ZD2021028) 

Foundation Item: Scientific Research Project of Jiangsu Provincial Health Commission (ZD2021028)

通讯作者:朱清毅,Email:drzhuqingy@126.com 

Corresponding Author: ZHU Qingyi, Email: drzhuqingy@126.com 

引用格式:魏勇,沈露明,沈百欣,等 . 运用国产单孔机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经验(附视频)[J]. 机器人外科学杂志(中英文),2024,5(1):13-19. 

Citation: WEI Y, SHEN L M, SHEN B X, et al. Primary experience of a domestic single-port robotic surgical system in retroperitoneal adrenalectomy (with video) [J]. Chinese Journal of Robotic Surgery, 2024, 5(1): 13-19.


参考文献

[1] Gavriilidis P, Camenzuli C, Paspala A, et al. Posterior retroperitoneoscopic versus laparoscopic transperitoneal adrenalectomy: a systematic review by an updated metaanalysis[J]. World J Surg, 2021, 45(1): 168-179.

[2] Gagner M, Lacroix A, Bolté E. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma[J]. N Engl J Med, 1992, 327(14): 1033. [3] Raffaelli M, De Crea C, Bellantone R. Laparoscopic adrenalectomy[J]. Gland Surg, 2019, 8(Suppl 1): S41-S52.

[4] Kook Y, Choi H R, Kang S W, et al. Laparoscopic adrenalectomy: comparison of outcomes between posterior retroperitoneoscopic and transperitoneal adrenalectomy with 10 years’ experience[J]. Gland Surg, 2021, 10(7): 2104-2112. 

[5] 吴震杰 , 王坚超 , 王杰 , 等 . 机器人单孔腹腔镜肾 上腺肿瘤切除术初步临床应用报告 [J]. 临床泌尿外 科杂志 , 2017, 32(6): 437-439, 443. 

[6] Garbens A, Morgan T, Cadeddu J A. Single port robotic surgery in urology[J]. Curr Urol Rep, 2021, 22(4): 22. 

[7] Horgan S, Vanuno D. Robots in laparoscopic surgery[J]. J Laparoendosc Adv Surg Tech A, 2001, 11(6): 415-419. 

[8] 王林辉 , 吴震杰 , 朱清毅 . 中国泌尿外科单孔腹腔 镜技术的发展与展望 [J]. 中华泌尿外科杂志 , 2020, 41(11): 807-810.

[9] Barret E, Sanchez-Salas R, Ercolani M, et al. Roboticassisted laparoendoscopic single-site surgery (R-LESS) in urology: an evidence-based analysis[J]. Minerva Urol Nefrol, 2011, 63(2): 115-122.

[10] Janetschek G. Robotics: will they give a new kick to single-site surgery? [J].Eur Urol, 2014, 66(6): 1044-1045.

[11] Kaouk J, Garisto J, Bertolo R. Robotic urologic surgical interventions performed with the single port dedicated platform: first clinical investigation[J].Eur Urol, 2019, 75 (4): 684-691. 

[12] 我国成功研发单孔手术机器人 [J]. 微创医学 , 2021, 16(2): 235.

[13] 张超 , 王正 , 张宗勤 , 等 . 国产单孔蛇形臂机器人 手术系统在零缺血肾部分切除术中的初步应用 [J]. 中华泌尿外科杂志 , 2022, 43(2): 132-137. 

[14] Economopoulos K P, Mylonas K S, Stamou A A, et al. Laparoscopic versus robotic adrenalectomy: a comprehensive meta-analysis[J]. Int J Surg, 2017. DOI: 10.1016/j.ijsu.2016.12.118. 

[15] Dobbs R W, Halgrimson W R, Talamini S, et al. Singleport robotic surgery: the next generation of minimally invasive urology[J]. World J Urol, 2020, 38(4): 897-905. 

[16] Lee I A, Kim J K, Kim K, et al. Robotic adrenalectomy using the da Vinci SP robotic system: technical feasibility comparison with single-port access using the da Vinci multi-arm robotic system[J]. Ann Surg Oncol, 2022, 29(5): 3085-3092. 

[17] Marek-Safiejko M, Safiejko K, Łukaszewicz J, et al. A comparison of two approaches to laparoscopic adrenalectomy: lateral transperitoneal versus posterior retroperitoneal approach[J]. Adv Clin Exp Med, 2016, 25(5): 829-835.

[18] Tutar O, Samanci C, Bakan S, et al. Typical MDCT angiography findings of an unusual cutaneous neoplasia; Masson tumor[J]. Pol J Radiol, 2015. DOI: 10.12659/ PJR.892043. 

[19] Holmes C, Akhras A, Schneider A, et al. Adrenal intravascular papillary endothelial hyperplasia[J]. World Journal of Endocrine Surgery, 2017, 9(1): 16-19.


本期文章
[1] 《机器人胸外科日间手术临床实践专家共识》解读 [2] 机器人辅助手术治疗子宫颈癌中国专家共识(2024 版): 附视频 [3] 国产手术机器人辅助下甲状腺癌根治术: 国内首例报道(附视频) [4] 机器人辅助单孔腹腔镜前列腺根治性切除术在中高危前列腺癌患者中的应用(附视频) [5] 加速康复外科理念下机器人辅助新生儿十二指肠隔膜切除术护理配合与管理 [6] 机器人辅助技术在妇科领域的研究进展 [7] 机器人辅助胰十二指肠切除术的学习曲线研究 [8] 眼科显微手术机器人的研究进展与临床应用 [9] 机器人辅助腹腔镜下新生儿先天性胆总管囊肿手术:国内首例报道(附视频) [10] 中国西部首例 5G 远程机器人辅助肾脏手术 (附视频) [11] 大数据环境下“互联网 + 健康教育”在体检中心慢性病患者护理管理中的方法与效果 [12] 思维导图式健康教育在机器人辅助胃癌根治术中的应用效果 [13] 达芬奇机器人手术运营效率影响因素分析 [14] 机器人辅助腹腔镜妇科手术影响患者安全的因素与优化措施 [15] 手术机器人在妇科恶性肿瘤手术中的临床应用分析 [16] 经腹膜外入路单孔手术机器人辅助前列腺癌根治术护理配合的初步经验 [17] 运用国产单孔机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经验(附视频) [18] 机器人辅助单孔腹腔镜前列腺根治性切除术中保留膀胱颈技术对术后尿控的效果研究(附视频) [19] 机器人辅助单孔腹腔镜技术在泌尿外科的发展与展望
印象笔记
有道云笔记
微博
QQ空间
微信
二维码
意见反馈