机器人在腹部外科手术中的初步应用(附16例报告)

Robotic abdominal surgery:An initial experience of 16 cases

目的总结达芬奇机器人系统在腹部外科手术中的初步应用体会。方法回顾分析2015年2月至10月间华中科技大学同济医学院附属协和医院胃肠外科行达芬奇机器人系统手术的16例病人资料。结果16例病人中男性7例，女性9例，均顺利完成达芬奇机器人辅助手术。手术方式为：全胃切除1例，远端胃癌根治术1例，胃局部切除术3例，食管裂孔疝修补加胃底折叠术2例，袖状胃切除术1例，十二指肠肿瘤切除术1例，胆囊切除术2例，胆总管囊肿加胆囊切除并胆肠吻合1例，乙状结肠癌根治术2例，直肠癌根治术2例。本组手术时间90~330min，系统装机时间20~60min。术中出血量为10~120ml，所有病人术中均未输血。胃肠道癌淋巴结检出数25．5枚／例。术后平均胃肠功能恢复时间为2．2d，术后平均住院时间为7．5d。本组病人术后恢复顺利，无严重并发症发生。结论达芬奇机器人手术系统在腹部外科手术中安全可行，具有解剖分离精准、创伤小、恢复快等优点。

Objective To summarize the clinical experience of 16 cases undergoing robot-assis- ted abdominal surgery. Methods Sixteen patients from Wuhan Union Hospital underwent da Vinci ro- bot-assisted abdominal surgery from Feb. 2015 to Oct. 2015. Data on demographics, clinical parame- ters, and medical records were reviewed. Results All operations were successfully accomplished, and there was no conversion to laparoscopic or open surgery. The operative time was 90-330 min. The in- traoperative blood loss was 10-120 mL and mean time for gastrointestinal function recovery was 2. 2 days. The mean number of harvested lymph nodes for gastrointestinal cancer was 25.5. The postoper- ative hospital stay was 7. 5 days. There was no serious postoperative complications and mortality. Condusions Robot-assisted abdominal surgery is safe and feasible in this small series of patients, with precise anatomical dissection, minimal trauma and fast recovery.