机器人辅助腹腔镜下耻骨上前列腺切除术

Robot-assisted laparoscopic suprapubic prostatectomy

目的探讨机器人辅助腹腔镜下耻骨上前列腺切除术治疗良性前列腺增生(BPH)的临床疗效。方法应用ZEUS机器人AESOP(USA)操作臂持镜机器人腹腔镜下耻骨上前列腺切除治疗BPH患者21例。前列腺平均体积90(68～160)mL,平均剩余尿110(60～300)mL。合并膀胱结石11例。结果 21例手术均获成功。手术时间90(90～210)min,平均130min;出血量70～420mL,平均210mL;术后膀胱冲洗2～6d,平均3.5d。住院时间4～9d,平均6.5d。手术前后最大尿流率分别为(4.10±3.43)(0～7.3)和(19.5±5.05)(15.2～26.8)mL/s。手术前后比较差异有显著性(P<0.05)。21例随访4～15个月无尿失禁及尿潴留发生。结论机器人辅助腹腔镜下耻骨上前列腺切除治疗良性前列腺增生使手术效率提高,操作更精确,手术更安全,疗效满意。

【Objrctive】To investigate the clinical efficacy of robot-assisted laparoscopic suprapubic prostatectomy. 【Methods】Twenty-one cases of benign prostatic hyperplasia （BPH） were treated by AESOP system （Computer Motion,USA） robot-assisted laparoscopic suprapubic prostatectomy. The average age was 65 years （range 60 ～ 79 years）. The prostate calculated volume by TRUS preoperative was 90 mL （rage 68～160 mL）. Mean value of residual urine was 110 mL （rage 60～300 mL）. Eleven cases were in presence of bladder caculi.【Results】All procedures were completely performed by robot-assisted laparoscopic suprapubic prostatectomy. The operative time was range from 90 to 210 min （average 130 min）. The average estimated blood loss was 200 mL （range 70～420 mL）. The postoperative bladder irrigation was 2～6 days （average 3.5 days）. The postoperative hospital time was 4 to 9 days （average 6.5 days） and urinary incontinence or retention was founded. During the follow up period （4～15 months）,maximum flow rate was [preoperative vs postoperative （4.10±3.43） （0～7.3） vs （19.35±5.05） （15.2～26.8,P 0.05）].【Conclusion】The ZESOP system robot-assisted laparoscopic suprapubic prostatectomy is a more effective,more precise,more safe,and minimally invasive.