国产康多手术机器人辅助腹腔镜根治性前列腺切除术  

Radical prostatectomy with a new surgical robot system,KD-SR-01

作　　者：王杰 张中元[1] 郝瀚[1] 代晓飞 朱军 虞巍[1] 樊书菠 熊盛炜 崔亮[2] 李学松[1] 周利群[1] 谌诚[1] Wang Jie;Zhang Zhongyuan;Hao Han;Dai Xiaofei;Zhu Jun;Yu Wei;Fan Shubo;Xiong Shengwei;Cui Liang;Li Xuesong;Zhou Liqun;Shen Cheng(Department of Urology,Peking University First Hospital.Institute of Urology,Peking University.National Urological Cancer Center,Beijing 100034,China;Department of Urology,Civil Aviation General Hospital,Civil Aviation Medical College of Peking University,Chaoyang District,Beijing 100123,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿男性生殖系肿瘤研究中心,100034 [2]北京大学民航临床医学院,民航总医院泌尿外科,100123

出　　处：《中华腔镜外科杂志（电子版）》2021年第5期318-320,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：患者全身麻醉满意后,先取平卧位,常规消毒、铺无菌单,留置尿管;经腹膜外入路,建立气腹(气腹压力12 mmHg,1 mmHg=0.133 kPa),Trocar采用5孔法。变换体位为头低足高位(Trendelenburg体位),对接机器人3D成像系统和各机械臂。游离、显露前列腺,2-0倒刺线缝扎阴茎背深静脉复合体;切开膀胱颈并继续向后方锐性游离精囊至狄氏筋膜;切开狄氏筋膜,钝性游离至前列腺尖部,切断双侧前列腺侧韧带;切断前列腺尖部尿道,完整切除前列腺。以1根2-0倒刺线将狄氏筋膜断端与尿道后正中嵴行连续缝合,另取1根2-0倒刺线将膀胱前列腺肌及膀胱后壁黏膜与尿道后正中嵴及尿道后壁黏膜连续缝合,使用3-0倒刺线双针法连续吻合膀胱颈和尿道;行尿道前方逼尿肌重建;重新留置F18双腔尿管,将切除组织置入标本袋自脐下切口取出,耻骨后留置F20引流管自右侧Trocar孔引出。After the general anesthesia was satisfied,the patient was placed in a supine position.Sterilized drapes were spread after the surgical area was disinfected,and then the urinary catheter was indwelled.The pneumoperitoneum was established via an extraperitoneal approach(pressure 12 mmHg,1 mmHg=0.133 kPa).A 5-hole method was used for port placement.Transforming the patient into the Trendelenburg position,and docking the robotic three-dimensional imaging system and the robotic arms.Exposing the prostate and stitching the deep dorsal penile venous complex with a 2-0 barbed thread.The anterior bladder neck was sectioned and the seminal vesicles were freed to Denonvillier′s fascia sharply.Cutting open the Denonvillier′s fascia and dissociating to the apex of prostate bluntly.The bilateral ligaments of prostate were sectioned respectively.The prostate was removed completely after the apex urethra was disconnected.A 2-0 barbed thread was used to suture the stump of Denonvillier’s fascia and the posterior median ridge of the urethra continuously,and a 2-0 barbed thread was used to connect the bladder prostatic muscle and the mucosa of the posterior bladder wall to the posterior median ridge of the urethra and the mucosa of the posterior urethra wall.The bladder neck and urethra were anastomosed continuously with the double needle method of 3-0 barbed thread.The detrusor skirt in front of the urethra was reconstructed.Finally,a F18 double-lumen urinary catheter was indwelled,the resected tissue was placed in the specimen bag and taken out from the subumbilical incision.A F20 drainage tube was indwelled behind the pubic bone and led out from the right trocar hole.

关 键 词：前列腺癌 康多 国产手术机器人 根治性前列腺切除术 

分 类 号：R69[医药卫生—泌尿科学]