摘要
目的探讨"一步法"机器人辅助腹腔镜行肾输尿管全长切除术在发挥微创技术优势,优化手术操作方面的作用。方法选择2017年1月至2017年12月在中国人民解放军兰州总医院行"一步法"机器人辅助腹腔镜下肾输尿管全长切除术的患者7例。手术体位取60°健侧卧位、整体15°头低脚高位;所有套管孔设计于患侧腹直肌旁一条直线上;在不更换患者体位、不重新连接机械臂的情况下顺利完成手术,肿瘤患者并完成区域淋巴结清扫。结果 7例患者中肾盂尿路上皮癌2例、输尿管尿路上皮癌3例、单侧肾输尿管结核2例,均成功完成手术治疗,无中转开放,病理明确诊断,术中估计出血量50~500mL,均痊愈出院,未发生严重并发症。结论 "一步法"机器人辅助腹腔镜下肾输尿管全长切除术,可使各手术器械间无干扰,不需调整体位或增加套管,也不用重新连接机械臂,可常规应用。
Objective To explore the minimally invasive advantage of"one-step"robot-assisted laparoscopic nephroureterectomy.Methods The clinical data of 7 patients undergoing robot-assisted laparoscopic nephroureterectomy during Jan.and Dec.2017 were retrospectively analyzed.The patients lay in a 60°flank position with a 15°Trendelenburg tilt.All ports were placed along the lateral rectus muscle in a straight line.The operation was performed successfully without repositioning patients or redocking the robot.Regional lymph node dissection was performed in all tumor patients.Results In all of the 7 cases,2 were renal pelvis urothelial carcinoma,3 were ureteral urothelial carcinoma,and2 were unilateral renal ureteral tuberculosis.All operations were completed successfully without conversion to open surgery.The intraoperative blood loss was 50-500 ml.All patients were cured without severe complications.Conclusion The"one-step"robot-assisted laparoscopic nephroureterectomy can be used routinely.It causes no interference among various surgical instruments.There is no need to reposition the patients or redock the robot.
作者
宋灵敏
蓝天
董永超
李卫平
何跃
王养民
SONG Ling-min;LAN Tian;DONG Yong-chao;LI Wei-ping;HE Yue;WANG Yang-min(Department of Urology,General Hospital of Lanzhou Military Command,Lanzhou 730050,China)
出处
《现代泌尿外科杂志》
CAS
2018年第8期591-594,共4页
Journal of Modern Urology
基金
甘肃省科技支撑计划(No.1504FKCA101)