da Vinci Si机器人治疗男性乳房发育症的临床研究

da Vinci Si surgical system in gynecomastia

目的：探讨da Vinci Si外科手术系统治疗男性乳房发育症的安全性及可行性。方法：2014年1月至2015年12月行da Vinci Si机器人手术治疗男性乳房发育症患者4例。取距离双乳乳腺腺体边缘2 cm的4点、6点、8点位做长约5 mm、8 mm、5 mm切口,双乳6点位切口作为da Vinci Si手术系统镜头入路,4点、右8点位接da Vinci Si手术系统1、2臂,1臂接超声刀,2臂接抓钳。术中止血及腺体切除均采用超声刀,标本于摄像臂切口取出,术毕于术区留置负压引流管并关闭手术切口。结果：4例均成功完成机器人男性乳房发育症皮下腺体切除术,无中转开放或腔镜手术及手术并发症发生,术中出血量20~30 ml,手术时间120~148 min,建立皮下隧道用时10~15 min（单侧）。结论：应用da Vinci Si外科手术系统行男性乳房发育症皮下腺体切除术安全、可行,手术美容效果较好。

Objective： To evaluate the safety and feasibility of da Vinci Si surgical system in gynecomastia. Methods： Roboticassisted surgery was performed for four gynecomastia patients in Jinan Military General Hospital of PLA from Jan. 2014 to Dec. 2015.5 mm,8 mm and 5 mm incision was made at 4,6 and 8 o’ clock point of 2 cm from breast edge. The endoscope of da Vinci Si operating system advanced through 6 o ’clock incision,arm 1 and 2 of da Vinci Si operating system was connected with 4 and right 8 o ’ clock point,ultrasonic knife was connected with arm 1,grasping forceps with arm 2. Ultrasonic scalpel was used for hemostasis and gland resection,and specimen was removed via the camera arm incision. The negative pressure drainage tube was placed at operative area after operation and the incision was closed. Results： Robotic subcutaneous mammectomy for gynecomastia was successful in four patients.There were no operation related complications and no conversion to open or endoscopic surgery. Blood loss during operation was about20-30 ml. Mean operation time was 120-148 min and time of subcutaneous tunnel establishment was 10-15 min for one side. Conclusions： The da Vinci Si surgical system is safe,feasible,and cosmetic in subcutaneous mammectomy for gynecomastia.