机器人“3+2”模式胃肠手术Trocar布置方法的总结与实践  

The experience on trocar layout method for robotic"3+2"mode gastrointestinal surgery

作　　者：狐鸣[1] 马雕龙 张文涛 马世勋[1] 杨婧[1] 郭进[1] 詹渭鹏[1] 马云涛[1] 蔡辉[1] Hu Ming;Ma Diaolong;Zhang Wentao;Ma Shixun;Yang Jing;Guo Jin;Zhan Weipeng;Ma Yuntao;Cai Hui(General Surgery Clinical Medicine Center,Gansu Provincial People's Hospital,Lanzhou 730000 China;The First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou 730000 China)

机构地区：[1]甘肃省人民医院普外临床医学中心,兰州730000 [2]甘肃中医药大学第一临床医学院,兰州730000

出　　处：《中华普通外科杂志》2023年第8期589-594,共6页Chinese Journal of General Surgery

基　　金：甘肃省委组织部甘肃省重点人才项目(2020RCXM076)。

摘　　要：目的本研究总结机器人“3+2”模式胃肠手术Trocar布孔原则和方法,以期为初学者提供帮助。方法2017年4月至2022年10月甘肃省人民医院机器人胃肠外科手术团队共完成998例机器人“3+2”模式胃肠手术,其中胃癌600例,直肠癌100例,降结肠、乙状结肠癌98例,横结肠癌20例,右半结肠癌180例。通过对术中遇到的问题进行不断优化和改进,结合术者操作体验,多方兼顾,制定出“3+2”模式胃肠手术Trocar布置方法。结果总结出四大布孔原则,即肚脐周围置镜原则、主操作对称原则、戳孔间距8~10 cm原则以及辅助孔镜头对称原则;制定出3种适用于机器人胃手术和4种适用于机器人结直肠手术的模式化布孔方法及原则。结论机器人“3+2”模式胃肠手术Trocar布置方法简便易学,可重复性和操作性强,适用于初学者,有望缩短初学者的学习曲线。Objective Based on experience of robotic gastrointestinal surgery at the Department of General Surgery,Clinical Medicine Center of Gansu Provincial Hospital,this study explored the principles and methods of trocar layout for robotic"3+2"mode gastrointestinal surgery,suitable for beginners.Methods From Apr 2017 to Oct 2022,the robotic gastrointestinal surgery team of Gansu Provincial Hospital completed 998 cases of robotic"3+2"mode gastrointestinal surgery,including 600 cases of gastric cancer,100 cases of rectal cancer,98 cases of descending colon and sigmoid colon cancer,20 cases of transverse colon cancer,and 180 cases of right colon cancer.Through the continuous optimization and improvement of the problems encountered during the operation,combined with the operator's experience,and taking into account various aspects,we developed the robotic"3+2"mode trocar layout for gastrointestinal surgery.Results Four principles of trocar layout were developed,namely,the principle of lens placement around the navel,the principle of symmetry in the main operation,the principle of 8-10cm distance between trocar holes,and the principle of symmetry in the auxiliary hole lens.Three trocar layout methods and principles applicable to robotic gastric surgery,and four applicable to robotic colorectal surgery were developed.Conclusion The trocar layout method of robotic"3+2"mode gastrointestinal surgery is established based on a large number of robotic gastrointestinal surgery experiences.This method is simple and easy to learn,with strong repeatability and operability.

关 键 词：机器人 消化系统外科手术 胃肿瘤 结直肠肿瘤 

分 类 号：R735[医药卫生—肿瘤]