机器人辅助腹腔镜泌尿外科手术中的早期应用体会*(附28例报告)

Preliminary experience in application of Da Vinci robotic surgery system in urinary surgery(Report of 28 cases)

目的:探究机器人辅助腹腔镜在泌尿外科手术的应用前景及疗效。方法:回顾性分析我院2016年8~12月使用达芬奇机器人手术辅助系统进行泌尿外科手术28例患者的临床资料。结果:28例手术中,上尿路手术包括10例肾上腺肿瘤切除术,4例肾癌根治性切除术,4例肾部分切除术,2例肾输尿管全长切除术,1例肾盂输尿管成形术;下尿路手术包括4例根治性前列腺切除术,1例输尿管膀胱再植术,2例盆腔肿物切除术。其中1例输尿管膀胱再植术患者术中因心功能不全中转开放,1例左侧巨大嗜铬细胞瘤手术因操作不当损伤脾脏后及时止血并顺利完成余下手术,其余26例手术均顺利完成。术后28例患者均无并发症。结论:机器人辅助手术系统可以应用于几乎所有泌尿系统的腹腔镜手术中,其优越性在泌尿系修复重建、泌尿系巨大占位和盆腔内占位等手术中体现更为明显。

Objective：To explore the prospect and effectiveness of robot-assisted laparoscopic technique in urological surgery.Method：A retrospective analysis of our department using da Vinci robot-assisted surgery system for 28 cases of urological surgery from August 2016 to December 2016 was done.Result：There were 21 upper tract surgeries and 7 lower tract surgeries.The upper tract surgeries included 10 cases of adrenal tumor resection,4 cases of radical nephrectomy,4 cases of partial nephrectomy,2 cases of nephroureterectomy and 1 case of pyeloplasty.The lower tract surgeries included 4 cases of radical prostatectomy,1 case of ureterovesical reimplantation and 2 cases of pelvic neoplasm resection.The ureterovesical reimplantation converted to open surgery,because the patient suffered from cardiac dysfunction during the operation.And owing to misoperation,one left adrenal pheochromocytoma resection happened rupture of spleen.The rest 26 cases were all performed successfully,and there were no serious perioperative complications in all of the operations.Conclusion：The robot-assisted surgery system can be applied to almost all of laparoscopic urological surgeries and its advantages are more obvious in the operations of the urinary reconstruction,huge tumor in the urological system and pelvic masses.