5G远程机器人辅助腹腔镜全子宫切除术首例报道  

5G Telesurgery Robot-assisted Laparoscopic Total Hysterectomy:First Report

作　　者：顾成磊[1] 李立安[1] 王宁[1] 范文生[1] 杨雯[1] 张洁 刘英 马兰兰 徐佳[1] 刘丹[1] 孟元光[1] Gu Chenglei;Li Li’an;Wang Ning(Department of Obstetrics and Gynecology,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100010,China)

机构地区：[1]解放军总医院第七医学中心妇产医学部,北京100010 [2]新疆维吾尔自治区皮山县人民医院妇产科,皮山845150

出　　处：《中国微创外科杂志》2023年第8期610-615,共6页Chinese Journal of Minimally Invasive Surgery

摘　　要：本文报道1例基于5G技术的相隔4000 km的远程机器人辅助腹腔镜全子宫切除术。患者52岁,牧民,因“不规则阴道出血1年,保守治疗效果不满意”入院新疆维吾尔自治区皮山县人民医院妇产科。宫腔镜检查+诊刮病理提示“子宫内膜复杂性增生”。性激素六项提示卵巢功能衰退。因居住偏远,就医困难,患者要求子宫切除手术。术前诊断子宫内膜复杂性增生,卵巢功能衰退。经解放军总医院第七医学中心妇产医学部会诊,决定施行远程机器人辅助腹腔镜全子宫双附件切除术。网络连接与保障通过公共5G无线网络(中国电信)和5G客户端设备(CPE)连接医生控制台与患者手术平台,然后通过5G核心网将数据从该站传输到目的站。北京电信和皮山电信通过在北京医生控制台上方和皮山县人民医院手术间均安装室分基站(华为)来增强信号质量,保障5G网络信号传输。现场由两地电信人员术中实时监测和保障网络信号,测试信号覆盖率100%,驻留比100%,空口时延20 ms。北京端网络带宽下行177 Mbps,上行101 Mbps,新疆端网络带宽下行282 Mbps,上行145 Mbps。2023年6月21日,由位于北京市的解放军总医院第七医学中心的医师,采用国产图迈四臂腔镜手术机器人系统,通过5G网络连接,为4000 km外的新疆维吾尔自治区皮山县人民医院的患者实施机器人辅助腹腔镜全子宫双附件切除术,手术顺利完成,手术时间62 min,出血5 ml,术中延时148.481~268.742 ms,平均161.959 ms,丢包率0.20%,未出现机器人及网络不良事件。术后第1天排气并进食,第2天拔除尿管,第3天出院,无术后并发症。术后病理:子宫内膜复杂性增生。术后4周门诊复查,患者无不适主诉,腹壁切口及阴道断端愈合良好。经系统查新,该例手术为5G远程机器人辅助腹腔镜全子宫切除术的首例报道。本例填补了5G远程机器人手术在妇科领域应用的空白,也初步探讨�This paper reported a case of telesurgery robot-assisted laparoscopic total hysterectomy based on 5G technology.A 52-year-old herdswoman was admitted to the Department of Obstetrics and Gynecology of the People’s Hospital of Pishan County,Xinjiang Uygur Autonomous Region due to“irregular vaginal bleeding for 1 year and unsatisfactory effect of conservative treatment”.Hysteroscopy combined with curettage showed“complicated hyperplasia of endometrium”.The results of six-hormone examination indicated ovarian failure.Due to the remoteness of the residence and the difficulty of accessing medical services,the patient requested a hysterectomy.Preoperative diagnosis was endometrial complex hyperplasia and ovarian failure.After consultation with the Department of Obstetrics and Gynecology,the Seventh Medical Center of Chinese PLA General Hospital in Beijing,we decided to perform a telesurgery robot-assisted laparoscopic total hysterectomy and bilateral salping-oophorectomy.The doctor’s console was connected to the patient’s surgical platform through the public 5G wireless network(China Telecom)and the 5G customer premise equipment(CPE),and then the data was transmitted from the station to the destination station through the 5G core network.The Beijing Telecom and Pishan Telecom had enhanced signal quality and guaranteed 5G network signal transmission by installing a sub-base station(Huawei)above the Beijing doctor’s console and in the operating room in the Pishan county.The network signal was monitored and guaranteed in real time by the telecom personnel of the two places.The test signal coverage rate was 100%,the resident ratio was 100%,and the air interface delay was 20 ms.Beijing’s network bandwidth was 177 Mbps downstream and 101 Mbps upstream,and Xinjiang’s network bandwidth was 282 Mbps downstream and 145 Mbps upstream.On June 21,2023,a doctor at the Seventh Medical Center of Chinese PLA General Hospital in Beijing used Tumai surgical robot system to perform robot-assisted laparoscopic total hyst

关 键 词：远程手术 机器人手术 妇科手术 全子宫切除术 

分 类 号：R713.42[医药卫生—妇产科学]