机器人辅助腹腔镜腹膜后肿瘤切除术的初步经验--附1例报告

Experience of Robot-assisted Laparoscopic Excision of Retroperitoneal Mass

目的探讨应用达芬奇机器人手术系统行后腹膜肿瘤切除术的安全性及手术效果。方法通过使用达芬奇机器人辅助腹腔镜手术系统行经腹入路的复杂腹膜后肿瘤切除术。患者为56岁女性,高血压病史5年,CT提示腹膜后6 cm左右类圆形肿块,血供丰富,肿瘤紧邻胰腺钩突和十二指肠后方,位于腹主动脉及下腔静脉之间,并压迫下腔静脉。结果手术取得成功,无中转开腹,无重要脏器、血管损伤。手术时间240 min,出血量约200 ml,术中血压平稳。术后恢复顺利,无并发症,于术后11天出院。病理为腹膜后副神经节瘤。结论机器人辅助微创手术系统能安全有效地进行腹腔内深在位置或大血管旁的腹膜后肿瘤的手术治疗。

Objective To discuss the safety and outcome of retroperitoneal tumor resection operated by the da Vinci robot-assisted laparoscopic system. Methods The da Vinci robot-assisted laparoscopic surgery system was used to remove complex retroperitoneal tumor by the abdominal approach. The patient was a 56-year-old female with a history of hypertension for 5 years. CT examination revealed a 6 cm mass adjacent to the uncinate process of pancreas and behind duodenum, between the abdominal aorta and inferior vena cava, with ample blood supply. Results The operation was accomplished without conversion to open surgery. No major organ or vascular injuries occurred. The operative time was 240 min, and the blood loss was 200 ml. No complication occurred, and the patient was discharged in good condition on l lth postoperative day. Pathology demonstrated a benign paraganglioma. Conclusion The da Vinci robot-assisted laparoscopic system can be used safely for the treatment of retroperitoneal tumor in tricky locations such as deep intraperitoneal position or next to great vessels.