机器人辅助全胸腺切除术初步报道  

Da Vinci surgical system for total thymectomy

作　　者：马永富[1] 杨博[1] 赵明[1] 褚剑[1] 晋帅 郭楠楠[1] 李捷[1] 张涛[1] 郭俊唐[1] 梁朝阳[1] 刘阳[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2017年第2期74-76,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：国家自然科学基金(81573026);首都市民健康项目培育基金(Z111100074911004)

摘　　要：目的探讨应用达芬奇机器人行全胸腺切除术的可行性及安全性。方法回顾性分析解放军总医院胸外科2015年5月至2016年4月利用达芬奇机器人系统行全胸腺切除手术的35例临床资料。手术采用三臂法:左侧机械臂为抓钳;右侧机械臂为电凝钩,必要时换为超声刀;中间为观察孔,根据肿瘤的位置和大小选择切口位置。对手术时间、术中出血量等情况进行分析,对手术患者体位、如何选取适宜的手术切口部位进行总结分析。结果 35例手术均获成功,手术时间(100.9±38.6)min,术中出血量(30.1±23.6)ml,术后24 h胸管引流量(132.2±58.3)ml,术后住院时间(4.4±2.1)d。无中转开胸及围手术期死亡病例。术后病理显示胸腺瘤30例、胸腺囊肿3例、胸腺增生2例。结论利用达芬奇机器人系统行全胸腺切除术,安全可靠,效果良好。Objective To investigate the feasibility and security of da Vinci surgical system in the treatment of anterior mediastinal tumor. Methods Department of Thoracic Surgery, Chinese PLA General Hospital From May 2015 to Apr. 2016,we prformed resection of mediastinal tumor 35 patients totally using da Vinci surgical system. Among the cases, the tumor was detected in the anterior mediastinum in 35 patients. Three ports were used in our procedure. The left mechanical arm for forceps. The right mechanical arm for electrocautery, and the ultrasonic scalpel will be changed when it needed, The middle hole for observation. Total thymectomy was performed on the patients with anterior mediastinal tumor. The operation time, intraoperative blood loss and other statistical analysis were carried out, and the body position of the patients and how to select the appropriate surgical incision were analyzed. Results The procedure was completed in all the 35 patients within （ 100.9 -＋ 38.6 ） min. The blood loss was （ 30. 1 -＋ 23.6 ） ml. Postoperative chest drainage volume of 24 h （ 132.2 -＋ 58.3） ml, postoperative hospitalization time （4.4 ＋ 2.1 ） d. No patient died or was converted to open surgery. Postoperative pathology showed 30 cases of thymoma, thymic cyst in 3 cases, thymic hyperplasia in 2 cases. Conclusions Da Vinci surgical system is feasible and safe for resection of anterior mediastinal tumor.

关 键 词：机器人辅助手术 胸腺切除术 精准医学 

分 类 号：R655.7[医药卫生—外科学]