机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术:全球首例报道(附视频)  

Robot-assisted laparoendoscopic single-site retroperitoneal living donor nephrectomy:the first case report(with video)

作　　者：沈百欣[1] 倪斌 张俊麒 郑明 魏勇 薛珺[1] 杨昕 朱清毅 顾民 SHEN Baixin;NI Bin;ZHANG Junqi;ZHENG Ming;WEI Yong;XUE Jun;YANG Xin;ZHU Qingyi;GU Min(Department of Urology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院泌尿外科,江苏南京210011

出　　处：《机器人外科学杂志（中英文）》2024年第2期233-237,共5页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金面上项目(82170769);江苏省卫生健康委科研项目(ZD2021028)。

摘　　要：南京医科大学第二附属医院泌尿外科于2023年5月收治1例“左侧供肾”患者,完成了首例机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术,该术式国内外尚无相关报道。手术顺利完成,未增加额外切口,术前机器人定位时间8 min,手术时间83 min,术中出血20 ml,热缺血时间3 min,冷缺血时间131 min。供肾动脉长3.5 cm,静脉长5.1 cm,输尿管长15 cm。皮肤切口长度为6 cm。供者术后复查肾功能正常,无任何围手术期并发症,术后3 d出院。肾移植术中再通血流后,移植肾色泽良好,张力正常,30 s后即有尿液流出,受者术后2 d血肌酐降至正常,未出现移植肾功能延迟恢复。结果表明,机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术具有安全、可靠、创伤小、恢复快、体表切口美观等优势,具有良好的临床应用前景。A case of left living kidney donor was admitted to the Department of Urology of the Second Affiliated Hospital of Nanjing Medical University in May 2023.The first case of robot-assisted laparoendoscopic single-site retroperitoneal living donor nephrectomy was performed in our hospital,which has not been reported at home and abroad.The procedure was carried out effectively without extra incision.The surgery was completed successfully with the estimated blood loss of 20 ml,total operative time of 83 min,warm ischemia of 3 min and cold ischemia of 131 min.Preoperative robotic positioning took 8 min.The ureter was 15 cm long,with the renal artery of 3.5 cm and vein of 5.1 cm.The skin incision was 6 cm in length.The donor had normal renal function on postoperative review without perioperative complications,with the length of hospital stay of 3 d.During kidney transplant,the graft was well perfused and normotonic after refilling of blood,and urine began to flow after 30 s.2 days after the surgery,the recipient’s serum creatinine returned to normal level without delayed graft function.The results showed that robot-assisted laparoendoscopic single-site retroperitoneal living donor nephrectomy is superior in surgical safety,dependability,minimal trauma,quick recovery,and aesthetic incision,which has good clinical prospects.

关 键 词：单孔腹腔镜手术 机器人辅助手术 供肾切取术 活体供肾 肾移植 

分 类 号：R608[医药卫生—外科学] R692[医药卫生—临床医学]