腹腔镜超声在机器人辅助腹部手术中的初步应用

Preliminary application of laparoscopic ultrasound in robot-assisted abdominal surgery

目的初步探讨腹腔镜超声在机器人辅助腹部手术中的临床价值。方法对6例患者(肝内胆管结石1例,肝占位2例,胰腺占位2例,腹膜后占位1例)实施腹腔镜超声引导下机器人辅助腹部手术治疗。应用术中腹腔镜超声:治疗前,探查病变部位、程度及与周围组织结构关系以选择手术方式;治疗时引导手术路径;治疗后,即刻初步评价疗效。手术后采用CT增强扫描或生化指标等进一步评价手术效果。结果 6例患者均成功完成腹腔镜超声引导机器人辅助腹部手术治疗,术中及术后均未出现严重并发症,生化指标恢复或接近正常水平,术后超声复查占位性病变治疗区未见血流信号,CT增强扫描未见强化,胆管超声与CT检查均未见异常。随访1～12个月,生存状况均较满意。结论腹腔镜超声在机器人辅助腹部手术中不仅可发挥引导定位作用,且可在术中指导手术方式的选择,有助于手术的成功实施。随着机器人手术的日益成熟,腹腔镜超声将成为实施该手术不可缺少的组成部分。

Objective To study the primary clinical application value of laparoscopic ultrasound in robot - assisted abdominal surgery. Methods A total of 6 patients（ 1 cases of bile duct stone, 2 cases of hepatic tumor, 2 cases of pancreatic tumur, 1 cases of tumor in retroperitoneal space） underwent the laparoseopi（ ultrasound - guided robot - assisted abdominal sugery.laparoscopic, ultrasound was used to determine the location and level of the lesion, relationship with the tissue nearby, and choose the best surgical method before the treatment; guide the patheway during the treatmeant; primarily evaluate the effect immediately after treatment. The results were evaluated by ultrasound, contrast - enhanced CT scans and biochemical parameters after operation. Results All surgical procedures were performed suceessfiully, and no intraoperative or postoperative complications occurred, biochemical blood parameters returned or approached to normal levels. In tumor area, color Doppler flow imaging showed no color signal and contrast -enhanced CT showed no enhancement. Ultrasonugraphy and CT detected no abnormality in the bile dt,＇t. During a mean follow - up period of 1 - 12 mouths, all pattens survived satisfactorily. Conclusion Laparoscopic ultrasound can not only locale the lesion and guide the pathway of operation, but also help surgeons to sele（11 the optilual operalic strateg）. With the development of robot -assisted surgical procedures, laparoseopic uhrasound will play a more important role.