机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征6例  

Robotic-assisted“3+1”Surgical Mode Strategy for 6 Cases of Median Arcuate Ligament Syndrome

作　　者：马于祺 马云涛[1] 马雕龙 杨婧[1] 詹渭鹏[1] 蔡辉[1] 狐鸣[1] Ma Yuqi;Ma Yuntao;Ma Diaolong(Department of General Surgery,Gansu Provincial People’s Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院普外一科,兰州730000 [2]甘肃中医药大学第一临床医学院,兰州730000

出　　处：《中国微创外科杂志》2024年第10期678-682,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：国家卫健委胃肠肿瘤诊治重点实验室课题(NLDTG2022009);甘肃省自然科学基金项目(22JR5RA663)。

摘　　要：目的探讨机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征(median arcuate ligament syndrome,MALS)的可行性。方法2019年6月~2023年10月我们采用机器人辅助下“3+1”手术模式治疗6例MALS。采用机器人辅助“3+1”手术模式(3个机械臂和1个助手孔的四孔操作方法),通过腹腔干血管游离方式,经脾动脉后方入路,解除正中弓状韧带对腹腔干的压迫。结果6例均成功完成机器人辅助下“3+1”模式手术。手术操作时间(包括接机和撤机的时间)38~52 min,平均43.2 min;术中出血量5~25 ml,平均15 ml。术后住院时间6~9 d,平均7.5 d。6例术后随访1~45个月(中位随访时间2.5月),1例体重未变,5例体重增加1.0~2.0 kg,平均1.5 kg;5例餐后上腹痛症状完全消失,1例症状减轻但未完全缓解。结论机器人辅助下“3+1”手术模式经脾动脉后方入路腹腔干血管游离方式治疗MALS安全可行。Objective To investigate the feasibility of robotic-assisted“3+1”surgical mode strategy for the treatment of median arcuate ligament syndrome(MALS).Methods Six patients diagnosed as MALS were enrolled between June 2019 and October 2023.The utilization of robotic-assisted“3+1”surgical mode(a 4-hole operation with 3 robot arms and 1 assistance hole)was carried out.Through a posterior splenic artery approach,the compression of the midline arcuate ligament on the abdominal trunk was relieved,which was an abdominal trunk vascularization.Results All the 6 patients underwent robotic-assisted“3+1”surgical mode successfully.The surgical duration(including the time for connecting and disconnecting the machine)was 38-52 min,with a mean of 43.2 min.The intraoperative bleeding volume was 5-25 ml,with a mean of 15 ml.The postoperative hospital stay was 6-9 d,with a mean of 7.5 d.All the 6 patients were followed up for 1-45 months after surgery(median,2.5 months).One patient remained unchanged in body weight,while 5 patients gained 1.0-2.0 kg in body weight,with a mean of 1.5 kg.The symptom of postprandial epigastric pain completely resolved in 5 patients,while the symptom was reduced but not completely alleviated in one patient.Conclusion Treatment of MALS with the robotic-assisted“3+1”surgical model involving abdominal trunk vascularization through a posterior splenic artery approach is safe and feasible.

关 键 词：正中弓状韧带综合征 机器人手术 

分 类 号：R654.3[医药卫生—外科学]