国产单孔蛇形臂机器人辅助优化后入路根治性前列腺切除术的初步经验(附手术视频)  

Initial experience with a domestically developed single-port serpentinearm robot-assisted optimized radical prostatectomy via posterior approach(with surgical video)

作　　者：刘洋[1] 刘子豪[1] 王准[1] 邵渊 杨振 黄华 王泽远 傅指南 牛远杰[1] 王勇[1] LIU Yang;LIU Zihao;WANG Zhun;SHAO Yuan;YANG Zhen;HUANG Hua;WANG Zeyuan;FU Zhinan;NIU Yuanjie;WANG Yong(Department of Urology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院泌尿外科,天津300211

出　　处：《机器人外科学杂志(中英文)》2025年第4期523-528,共6页Chinese Journal of Robotic Surgery

基　　金：天津医科大学第二医院泌尿人才孵育项目(2023ZDSYS06);天津医科大学第二医院院青年基金项目(2022YDEY18)。

摘　　要：目的:研究国产术锐^(®)单孔蛇形臂手术系统行逆行松解神经血管束且保留Retzius间隙的优化后入路机器人辅助根治性前列腺切除术的安全性与可行性,并报道初步经验。方法:收集2023年10月—2023年11月在天津医科大学第二医院就诊并接受国产“术锐”单孔蛇形臂机器人辅助根治性前列腺切除术的3例患者的临床资料,2例采用逆行松解神经血管束且保留Retzius间隙的改良后入路,1例采用前后联合入路,分析患者围手术期资料及随访数据。结果:3例手术均顺利完成,自切皮至缝合伤口完毕的手术总时间为248(217~286)min,其中腔内手术时间为212(180~255)min,术中出血量为306(120~500)mL。3例患者均未发生术后并发症,切缘均为阴性,其中2例实现拔管即刻尿控,1例实现拔管1周后尿控,术后1个月及12个月PSA均控制良好,未出现生化复发。结论:采用国产术锐^(®)单孔蛇形臂手术系统可以安全地进行逆行松解神经血管束且保留Retzius间隙的优化后入路机器人辅助根治性前列腺切除术,术后短期随访满意。Objective:To assess the safety and feasibility of radical prostatectomy via an optimized posterior approach using the domestically developed SHURUI single-port serpentine-arm robotic surgical system,featuring retrograde neurovascular bundle(NVB)release with Retzius-sparing technique,and to report preliminary clinical outcomes.Methods:Clinical data from 3 patients who underwent SHURUI single-port robot-assisted radical prostatectomy at the Second Hospital of Tianjin Medical University from October 2023 to November 2023 were analyzed.2 patients received the modified posterior approach(retrograde NVB release with Retziussparing),while 1 patient underwent a combined anterior-posterior approach.Perioperative parameters and follow-up data were evaluated.Results:All procedures were successfully completed.Total operative time(from skin incision to wound closure)was 248(217~286)min,with console time of 212(180~255)min.Intraoperative bleeding was 306(120~500)mL.No postoperative complications occurred.Surgical margins were negative in all cases.Immediate urinary continence was achieved in 2 patients after removal of catheter,with 1 patient attaining continence within one week.PSA levels remained well-controlled at 1 and 12 months after surgery,with no biochemical recurrence.Conclusion:The domestically developed SHURUI single-port serpentine-arm robotic surgical system can be used to perform radical prostatectomy via the optimized posterior approach safely incorporating retrograde NVB release and Retzius-sparing techniques,with satisfied short-term follow-up outcomes.

关 键 词：单孔手术机器人 机器人辅助手术 手术入路 根治性前列腺切除术 

分 类 号：R697.3[医药卫生—泌尿科学]