机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术3例报告  

Robotic transumbilical laparoendoscopic single-site renal cyst decortication:Report of 3 cases

作　　者：马鑫[1] 张旭[1] 董隽[1] 高江平[1] 陈光富[1] 卢锦山[1] 史立新[1] 孙圣坤[1] 祖强[1] 黄双[1] 祝强[1] 明少雄 

机构地区：[1]中国人民解放军总医院泌尿外科,北京100853

出　　处：《微创泌尿外科杂志》2014年第1期8-11,共4页Journal of Minimally Invasive Urology

基　　金：卫生部行业基金子课题(201002010)

摘　　要：目的：初步探索机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术的安全性和可行性.方法：2013年12月~2014年1月,开展机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术3例.患者取45°健侧卧位,作患侧脐缘2cm切口,Hasson法制备经脐入路机器人单孔腹腔镜手术通道切口,置入机器人单孔多通道Port装置,从通道中分别置入1个8．5mm镜头套管、两个5mm器械套管及1个5mm辅助套管,连接安装床旁机械臂和观察镜,按照标准经腹入路腹腔镜肾囊肿去顶减压术的操作步骤完成手术,术中标本经脐部切口取出.结果：3例手术均成功完成,手术时间分别为75、65和50min,估计出血量分别约20、15和10ml,术后住院日分别为2、3及3天,无中转开放或标准三孔腹腔镜手术,未发生围手术期并发症,3例患者术后病理均提示肾囊肿,短期随访无术后并发症发生.结论：初步经验表明机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术安全、可行.但目前完成病例数较少,其临床治疗效果尚需大样本、多中心的长期随访及随机对照研究予以验证.Objective:To investigate the clinical safety and feasibility of robotic transumbilical laparoendoscopic single-site renal cyst decortication.Methods:From December 2013 to January 2014 ,3 cases of robotic transumbilical laparoendoscopic single-site renal cyst decortication were perfor med in our depart ment .The patient was placed in a 45°flankpositionfortransperitonealsurgery.A2-cmskinincisionaroundtheumbilicus was madeanddeepenedto the anterior rectus fascia ,then the peritoneum was incised and the Port was deployed .A8 .5-mmvideo-laparoscope , two 5-mmtrocars and a 5-mm assisted trocar were inserted through the Port syste m.Diagnostic laparoscopy was perfor med before robotic checking .The operative robot then was brought in over the patient'healthy side .Standard procedureoflaparoscopicrenalcystdecorticationwasperformed.Thespecimens wereremovedthroughtheumbilical incision.Results:Three cases of robotic transumbilical laparoendoscopic single-site renal cyst decortication were per-for med successfully with no conversion to open or 3-port laparoscopic approach .The operative ti me was 75 ,65 and 50 min,theestimatedbloodloss was20,15and10 mL,andthepostoperativehospitalstaywas2,3and3days,re-spectively.Nointro-operative complication was observed.There was no postoperative complications during a short follow-up period .Conclusions:Initial experience on robotic transumbilical laparoendoscopic single-site renal cyst decorticationhadshownitsclinicalsafetyandfeasibility.However,thoseresultsshouldbefurtherprovedbylarge sample,multiplecenters,randomcontrol studyandlong-termfollow-up.

关 键 词：机器人 单孔腹腔镜手术 肾囊肿去顶减压术 

分 类 号：R692[医药卫生—泌尿科学]