机器人辅助腹腔镜下腹膜后淋巴结清扫术六例报告  

Experiences of robot-assisted laparoscopic retroperitoneal lymph node dissection: 6 cases report

作　　者：张尧 毕罡 张军 黄灶明 李珂 舒泽华 江军 Zhang Yao;Bi Gang;Zhang Jun;Huang Zaoming;Li Ke;Shu Zehua;Jiang Jun(Department of Urology,Army Medical Center,Chongqing 400042,China)

机构地区：[1]陆军特色医学中心泌尿外科,重庆400042

出　　处：《中华腔镜泌尿外科杂志（电子版）》2020年第2期96-99,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的总结6例机器人辅助腹腔镜下腹膜后淋巴结清扫术,对该手术的技巧方法和经验教训进行初步探讨。方法患者均为青年男性,睾丸胚胎癌根治术后,行机器人辅助腹腔镜下腹膜后淋巴结清扫术。手术体位采用健侧斜侧卧位+轻度折刀位,穿刺孔取脐旁为观察孔,常规取3个机器人操作手臂及2个助手孔,手术范围为标准清扫范围,清除所有患侧腹膜后淋巴组织。结果手术成功完成,术中出血100~250 ml,术后恢复良好。术后病理未发现淋巴结转移。结论机器人辅助腹腔镜下腹膜后淋巴结清扫术相对难度高,手术体位和穿刺孔的选择对手术成功与否至关重要,其精准和灵活的操作可以使患者明显受益,对交感干、腹主动脉及其分支、腔静脉及其分支的保护优于普通腹腔镜。Objective To summarize 6 cases of laparoscopic retroperitoneal lymph node dissection, and to explore the techniques and lessons of the operation. Methods All the patients were young men. After radical operation of testicular embryonic cancer, a robot-assisted laparoscopic hypogastric lymph node dissection was performed. The contralateral lateral decubitus position + mild jackknife position for surgery, observation hole located in the belly button, 3 robot operating arm and 2 assistant hole operation range for standard dissection, all retroperitoneal lymphes were removed. Results The operations were successfully completed, with about 100-250 ml of intraoperative blood loss. Patients recovered well after operation. Metastasis of tumor lymph nodes was not found by postoperative pathology. Conclusion Robotic-assisted laparoscopic retroperitoneal lymph node dissection is relatively difficult. The choice of surgical position and puncture hole is critical to the success of surgery. The precise and flexible operation of robot system can significantly benefit patients, and the protection of sympathetic trunk, abdominal aorta and its branches, vena cava and its branches is better than that of general laparoscopy.

关 键 词：非精原细胞瘤 机器人 腹腔镜 腹膜后 淋巴结清扫术 

分 类 号：R737.21[医药卫生—肿瘤] TP242[医药卫生—临床医学]