机器人辅助单孔腹腔镜手术治疗儿童先天性胆总管囊肿(附手术视频)  

Robot-assisted laparoscopic single-site surgery for congenital choledochal cysts in children(with surgical video)

作　　者：杜国伟 高贺云 胡涛 王迎心 刘一帆[1] 骆明双 郭云凯 李庚 张文[1] DU Guowei;GAO Heyun;HU Tao;WANG Yingxin;LIU Yifan;LUO Mingshuang;GUO Yunkai;LI Geng;ZHANG Wen(Department of Pediatric Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院小儿外科,湖北武汉430071

出　　处：《机器人外科学杂志(中英文)》2025年第3期379-382,共4页Chinese Journal of Robotic Surgery

基　　金：儿童单孔机器人技术应用研究项目(YYXKNLJS2024020)。

摘　　要：目的:分析总结第四代达芬奇机器人辅助单孔腹腔镜手术(R-LESS)治疗儿童先天性胆总管囊肿的疗效和经验。方法:回顾性分析2020年5月—2023年5月武汉大学中南医院小儿外科收治的3例行机器人辅助单孔腹腔镜下胆总管囊肿根治术的患儿临床资料。所有患儿均为女性;年龄分别为31 d、50 d和4岁。Todani分型:1例为Ia型囊肿,2例为IVa型囊肿。3例患儿先在腹腔镜模式下探查、定位空肠并拖出体外,再行空肠-空肠端侧吻合,然后在机器人辅助单孔腹腔镜下行胆囊切除+胆总管囊肿切除+肝总管空肠端侧吻合。结果:3例手术均顺利完成,无中转开腹。平均手术时间252 min,术中出血量5~15 mL。术后第3 d患儿开始进食,术后平均住院时间为7 d。随访时间为6~18个月,平均12.7个月,无胆瘘、胰瘘、吻合口狭窄等并发症发生。结论:第四代达芬奇机器人辅助单孔腹腔镜手术治疗儿童先天性胆总管囊肿是安全、有效的,且切口隐匿、美观。Objective:To analyze and summarize the effect and experience of Da Vinci Xi robot-assisted laparoscopic singlesite surgery(R-LESS)for treating congenital choledochal cyst in children.Methods:Clinical data of 3 children who underwent R-LESS for choledochal cyst in the Department of Pediatric Surgery of Zhongnan Hospital of Wuhan University from May 2020 to May 2023 were retrospectively analyzed.All children were female,aged 31 days,50 days,and 4 years,respectively.There were onecase of Todani type Ia cyst and 2 cases of type IVa cyst.In the 3 cases,the jejunum was first explored,localized and dragged out in vitro under laparoscopic mode,then jejunum-jejunum end-side anastomosis was performed,followed by robotassisted single-site laparoscopic cholecystectomy+choledochal cyst excision+hepatic duct-jejunum end-side anastomosis.Results:All the 3 case of surgeries went smoothly without conversion to laparotomy.The average operative time was 252 min and intraoperative bleeding was 5~15 mL.The children started to eat on the 3rd day after surgery,and the average postoperative hospitalization was 7 d.The follow-up period ranged from 6 to 18 months,with a mean length of 12.7 months,and there were no complications such as biliary fistula,pancreatic fistula,or anastomotic stenosis occurred.Conclusion:For the treatment of congenital choledochal cysts in children,R-LESS is both safe and feasible,and the incision could be hidden and aesthetically pleasing.

关 键 词：机器人辅助手术 单孔腹腔镜 胆总管囊肿 儿童 

分 类 号：R726.5[医药卫生—儿科]