应用达芬奇机器人手术系统辅助直肠癌前切除术11例体会  

Experience of Da Vinci Robotics-Assisted Dixon Procedure for Rectal Cancer in 11 Cases

作　　者：李瑾[1] 张成[1] 蒋会勇[1] 吕赤[1] 吕晨光[1] 郭一君[1] 高广荣[1] 张雪峰[1] 

机构地区：[1]沈阳军区总医院普通外科,辽宁沈阳110016

出　　处：《中国普外基础与临床杂志》2012年第12期1319-1322,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结达芬奇机器人手术系统在直肠癌前切除术中的应用体会。方法笔者于2011年5月至2012年1月期间应用腹腔镜联合达芬奇机器人手术系统实施了直肠癌前切除术11例。均采用4孔法;先行腹腔镜探查,确定具有达芬奇机器人手术的可行性后,再在腹腔镜引导下放置戳卡,摆放体位,经腹壁悬吊乙状结肠及子宫;镜下分离解剖应用达芬奇机器人手术系统;直肠的离断及吻合转在腹腔镜下完成。回顾性分析该11例患者的临床资料,并总结手术体会。结果 11例患者均顺利完成手术,均未中转开腹;手术时间210～330 min,平均288.6 min;术中出血量20～100 ml,平均40 ml;清扫淋巴结数量12～21枚/例,平均13.9枚/例;术后排气时间18～26 h,平均22 h;术后住院时间7～16 d,平均11.5 d;术中及术后均未出现并发症;术后病理学检查示切缘均未见癌细胞残留。结论应用达芬奇机器人手术系统实施直肠癌前切除术安全可行,其手术创伤小,患者术后恢复快。Objective To summary the early experience of Dixon procedures with Da Vinci robotics surgical system for rectal cancer.Methods Eleven patients with rectal cancer underwent the combination of laparoscope and Da Vinci robotics surgical system with 4 trocars in our hospital from May.2011 to Jan.2012.Laparoscopy was firstly used to identify the possibility of the surgical procedure,then placed the 4 trocars,and maked sure the suspension of the sigmoid colon and the uterus.Transections of rectum were performed by a conventional laparoscopic method,and endoscopic separations were performed by Da Vinci robotics surgical system.The clinical data were retrospectively analyzed and the experience was summarized.Results The Da Vinci robotics-assisted Dixon procedures were successfully performed in 11 patients and no one turned to laparotomy.The operating time was 210-330min（mean 288.6min）;the blood loss was 20-100ml（mean 40ml）;The number of lymph nodes dissected was 12-21 per case（mean 13.9 per case）;the duration of bowel movement and hospital stay were 18-26h（mean 22h） and 7-16d（mean 11.5d）,respectively.There were no intraoperative or postoperative complications related to the use of robotics,and no residual cancer cells at resection margin.Conclusion sDa Vinci robotics-assisted Dixion procedure with 4 trocars and suspension of sigmoid colon are safe and feasible,and it is beneficial to the recovery of patients.

关 键 词：直肠癌 达芬奇机器人手术系统 前切除术 

分 类 号：R735.37[医药卫生—肿瘤]