基于5G通信技术的机器人辅助远程泌尿外科手术的临床应用研究  

Clinical application research of 5G-based robot-assisted remote urological surgery

作　　者：黄韵翰 吕海迪 周逢海 冯彬[1] 张晓峰 郭柏鸿[1] Huang Yunhan;Lyu Haidi;Zhou Fenghai;Feng Bin;Zhang Xiaofeng;Guo Baihong(Department of Urology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院泌尿外科,兰州730000

出　　处：《中华泌尿外科杂志》2025年第1期49-54,共6页Chinese Journal of Urology

摘　　要：目的探讨5G通信技术联合国产机器人手术系统实施多术式远程泌尿外科手术的可行性和安全性。方法本研究为前瞻性单臂研究,纳入2023年5月至2024年6月甘肃省人民医院拟行泌尿外科腔镜手术治疗的良性病变或肿瘤患者。纳入标准:年龄≥18岁;体质量指数(BMI)18~30 kg/m^(2);美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级;肿瘤指标符合以下手术指征之一,肾肿瘤分期≤T 2期、单发或肿瘤最大径≤10 cm,中低危前列腺癌(临床分期≤T 2b期)、术前前列腺特异性抗原(PSA)≤20 ng/ml或Gleason评分≤7分,肾上腺肿瘤直径≤7 cm(如为无功能腺瘤则肿瘤直径≥3 cm),膀胱肿瘤分期≤T 2期。排除标准:近1个月内参与过其他研究性药物或器械临床研究;妊娠或哺乳期女性;需行急诊手术者;有严重心血管或循环系统疾病无法耐受手术者;伴有癫痫、精神病史、认知障碍者;存在活动性出血、凝血功能异常或血小板计数<80×109/L者。在甘肃省人民医院本部与新区分院(网络通信距离约70 km)之间建立5G通信连接,借助国产机器人手术系统(图迈MT-1000)实施远程手术。记录围手术期主要指标、术中网络情况及机器人运行情况。结果本研究共纳入14例患者,其中肾囊肿3例,肾肿瘤3例,无功能肾3例,肾上腺肿瘤2例,膀胱肿瘤1例,前列腺癌1例,输尿管膀胱壁内段增厚伴盆段结石1例。男7例,女7例;年龄(57.4±12.3)岁;BMI(24.6±3.0)kg/m^(2);ASA分级Ⅱ级9例,Ⅲ级5例。所有远程手术均顺利完成,无中转为其他手术者。肾囊肿去顶减压术3例,主控端操作时间(32.0±6.6)min,术中出血量(13.3±2.9)ml。肾部分切除术2例,主控端操作时间分别为140、160 min,术中出血量均为20 ml,热缺血时间分别为19、25 min;患者术前估算肾小球滤过率(eGFR)分别为115.2、107.3 ml/(min·1.73m^(2)),术后分别为102.0、95.5 ml/(min·1.73m^(2))。根治性肾切除术4例,主控端操作时间(50.2±13.7)miObjectiveTo evaluate the feasibility and safety of performing multi-procedure remote urological surgeries by integrating 5G communication technology with domestically manufactured robotic surgical systems.MethodsPatients requiring urological laparoscopic surgery for benign lesions or tumors were prospectively enrolled at Gansu Provincial Hospital from May 2023 to June 2024.Inclusion criteria included age≥18 years,body mass index(BMI)between 18 and 30 kg/m^(2),and American Society of Anesthesiologists(ASA)classificationⅠ-Ⅲ.Tumor-related surgical indicators were as follows:renal tumors staged≤T 2,solitary tumors,or maximum diameter≤10 cm;intermediate-to low-risk prostate cancer(clinical stage≤T 2b),with preoperative prostate-specific antigen(PSA)≤20 ng/ml or Gleason score≤7;adrenal tumors with a diameter≤7 cm or≥3 cm for non-functional adenomas;and bladder tumors staged≤T 2.Exclusion criteria included participation in other investigational drug or device clinical trials within the past 1 month,pregnancy or breastfeeding,and patients requiring emergency surgery.Patients with severe cardiovascular or circulatory diseases contraindicating surgery,and individuals with epilepsy,psychiatric disorders,or cognitive impairments were also excluded.Additionally,patients with active bleeding,coagulation disorders,or platelet counts<80×109/L were excluded.A 5G communication link was established between the main campus and the new branch of Gansu Provincial Hospital,approximately 70 km apart.Remote surgeries were performed using the domestically manufactured robotic surgical system(Toumai MT-1000).Perioperative key indicators,intraoperative network conditions,and robotic system performance were systematically recorded.ResultsThis study involved 14 patients,comprising 3 cases of renal cysts,3 cases of renal tumors,3 cases of nonfunctional kidneys,2 cases of adrenal tumors,1 case of bladder tumor,1 case of prostate cancer,and 1 case of ureteral-bladder wall thickening with pelvic ureteral stones.The cohort i

关 键 词：泌尿外科 机器人辅助手术 5G通信技术 远程手术 

分 类 号：R737.1[医药卫生—肿瘤]