达芬奇机器人手术系统在妇科腹腔镜手术中的应用

Application of Da Vinci's robot in gynecological laparoscopic surgery

目的探讨达芬奇机器人手术系统辅助妇科腹腔镜手术的安全性及可行性。方法回顾性分析2016年11月至2018年6月首都医科大学附属北京安贞医院16例因良恶性肿瘤行达芬奇机器人手术系统辅助腹腔镜下妇科手术患者的病历资料。结果 16例患者手术时间70～390 min,平均(212±89)min;术中出血量5～200 ml,平均(99±58)ml;术后肠道功能恢复时间6～54 h,平均(40±16)h;膀胱功能恢复中位时间为24. 5 (20. 0,162. 5) h;术后72 h引流量10～400 ml,平均(206±123) ml;术后腹部切口拆线时间72～120h,平均(112±17)h;切除淋巴结数目25～45个,平均(32±6)个;住院时间3～14 d,平均(8±4)d。无中转开腹手术者。术后1例患者发生盆腔感染。患者术后随访2～13个月,均未发现肿瘤复发或转移。结论达芬奇机器人手术系统应用于妇科领域安全、有效、可行,适用手术范围及病种较广泛,对于恶性肿瘤的治疗有明显优势,视野清晰,出血量明显减少。

Objective To explore the safety and feasibility of gynecological laparoscopic surgery assisted by Da Vinci′s robot. Methods Clinical data of 16 cases of gynecological laparoscopic surgery for benign and malignant tumors assisted by Da Vinci′s robot performed in Beijing Anzhen Hospital, Capital Medical University from November 2016 to June 2018 were retrospectively analyzed. Results Operation time was 70-390 min with a mean of (212±89)min. Intraoperative blood loss was 5-200 ml with a mean of (99±58)ml. Postoperative intestinal function recovery time was 6-54 h with a mean of (40±16)h. The medium bladder function recovery time was 24.5(20.0, 162.5)h. Postoperative 72 h drainage volume was 10-400 ml with a mean of (206±123)ml. Suture removal time was 72-120 h with a mean of (112±17)h. The number of lymph nodes removed was 25-45;the mean number was (32±6). Hospitalization time was 3-14 d with a mean of (8±4)d. There was no conversion to laparotomy. Pelvic infection occurred in 1 patient. No tumor recurrence or metastasis was observed in 2-13 months after operation. Conclusions Da Vinci′s surgical robot system applied in gynecology is safe, effective, feasible and applicable with advantages such as clear surgical field and little blood loss.