Maryland双极镊在机器人辅助胃癌根治术中的临床应用(附手术视频)  

Clinical application of Maryland bipolar forceps in robot-assisted distal gastrectomy for gastric cancer(with surgical video)

作　　者：王友朋 孙旭 刘炜 李腾腾 张轩 王凯 付海啸 符炜 WANG Youpeng;SUN Xu;LIU Wei;LI Tengteng;ZHANG Xuan;WANG Kai;FU Haixiao;FU Wei(Department of Gastrointestinal Surgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院胃肠外科,江苏徐州221006

出　　处：《机器人外科学杂志（中英文）》2024年第6期1171-1178,共8页Chinese Journal of Robotic Surgery

基　　金：徐州市卫健委青年医学科技创新项目(XWKYHT20230057)。

摘　　要：目的:比较两种能量器械Maryland双极(MB)镊和超声刀(US)在达芬奇机器人辅助腹腔镜下远端胃癌根治术中的应用效果。方法:回顾性分析2020年2月—2024年2月徐州医科大学附属医院胃肠外科收治的65例达芬奇机器人辅助腹腔镜下远端胃癌根治术患者的临床资料,其中以MB作为能量器械的31例患者分为MB组,以US作为能量器械的34例患者分为US组。比较两组患者术后的C-反应蛋白水平、术后腹腔引流液淀粉酶水平、胰腺上缘淋巴结清扫总数、淋巴结清扫总数、胰腺上缘淋巴结清扫时间、手术时间、术中出血量、术后排气时间、住院费用、并发症等指标。结果:MB组患者术后第1 d、第3 d C-反应蛋白水平和术后第2 d、第3 d腹腔引流液淀粉酶水平较US组更低,术中No.8a清扫数目和胰腺上缘淋巴结清扫总数更多以及住院费用更少,差异具有统计学意义(P<0.05)。两组患者在胰腺上缘淋巴结清扫时间、手术时间、术中出血量、术后排气时间、引流管拔出时间等方面比较,差异均无统计学意义(P>0.05)。结论:与US相比,MB在达芬奇机器人系统辅助下胃癌根治术中的应用具有一定优势,是一种安全可靠的能量装置。Objective:To compare the application effect of MARYLAND bipolar forceps(MB)and ultrasonic scalpel(US)in Da Vinci robot-assisted laparoscopic distal gastrectomy for gastric cancer.Methods:Clinical data of 65 patients who underwent Da Vinci robot-assisted distal gastrectomy for gastric cancer in the Affiliated Hospital of Xuzhou Medical University from February 2020 to February 2024 were retrospectively analyzed,of which 31 cases were divided into the MB group by using Maryland bipolar forceps as the energy instrument and 34 cases were divided into the US group by using ultrasonic scalpel as the energy instrument.The postoperative C-reactive protein level,postoperative amylase level of abdominal drainage fluid,total number of dissected superior pancreatic nodes,total number of dissected lymph nodes,superior pancreatic nodes dissection time,operative time,intraoperative bleeding,postoperative exhausting time,hospitalization cost,and complications were compared between the two groups of patients.Results:Compared with the US group,the MB group had lower C-reactive protein levels at 1st d and 3rd d after surgery and lower amylase levels in the abdominal drainage fluid at the 2nd d and 3rd d after surgery,a higher number of dissected No.8a lymph node and total number of dissected superior pancreatic nodes,and a lower hospitalization cost,and the differences were statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of superior pancreatic nodes dissection time,operative time,intraoperative bleeding,postoperative exhausting time,drainage tube removal time,and postoperative hospitalization time(P>0.05).Conclusion:Compared with US,MB has certain advantages in Da Vinci robot-assisted laparoscopic distal gastrectomy for gastric cancer,which is a safe and reliable energy device.

关 键 词：机器人辅助手术 胃癌根治术 能量装置 Maryland双极镊 超声刀 

分 类 号：R656.6[医药卫生—外科学] R735.2[医药卫生—临床医学]