机器人单孔腹腔镜妇科手术11例临床观察

Robotic-assisted laparoendoscopic single-site gynecologic surgery: a report of 11 cases

目的探讨达芬奇机器人单孔腹腔镜手术系统施行妇科手术的安全性及可行性。方法回顾性分析解放军总医院妇产科2017年12月至2018年1月为11例患者施行达芬奇机器人单孔腹腔镜手术系统辅助妇科手术的临床资料。结果达芬奇机器人单孔腹腔镜手术系统共施行11例妇科手术,均获得成功。包括卵巢囊肿剥除术4例,全子宫+双附件切除术3例,子宫肌瘤剔除+卵巢囊肿剥除术1例,盆腔粘连松解+卵巢囊肿剥除术1例,单侧附件切除术1例,输卵管系膜囊肿剥除术1例。手术操作时间(49. 0±19. 3) min,术中出血量(33. 6±24. 2) ml,术后排气时间(17. 3±3. 1) h,术后住院时间(2. 3±0. 9) d。11例患者在术中、术后均无并发症发生,均痊愈出院。术后随访患者脐部切口隐蔽,瘢痕不易发觉。结论达芬奇机器人单孔腹腔镜手术系统应用于妇科领域是安全、可行的,但要求术者要熟悉盆腔解剖结构,而且应具备娴熟的腹腔镜技术。

Objective To investigate the safety and feasibility of the da Vinci robot- assisted laparoendoscopic single- site gynecologic surgery. Methods The clinical data were reviewed retrospectively in 11 patients undergoing da Vinci robot- assisted laparoendoscopic single- site gynecologic surgery from Dec. 2017 to Jan.2018 in Chinese PLA General Hospital. Results Robot- assisted laparoendoscopic single- site surgeries were successfully finished in all 11 cases.These gynecologic procedures including four ovarian cystectomies,three hysterectomies and bilateral salpingo- oophorectomies,one myomectomy and ovarian cystectomy, one pelvic adhesiolysis and ovarian cystectomy, one single salpingo- oophorectomubtotal hysterectomy,one mesosalpinx cystectomy. The console time was （49.0±19.3）min. The intra- operative blood loss was （33.6 ± 24.2）ml. The time of postoperative bowel recovery was （17.3±3.1）h and the postoperative hospital stay time was（2.3± 0.9）d.There were no intraoperative or postoperative complications in all cases.Single- site procedures were associated with good esthetic results because of minor abdominal trauma. Conclusions Robot- assisted laparoendoscopic single- site gynecologic surgeries are safe and feasible.The surgeons should master the anatomy of the pelvic cavity and master the laparoscopic technique skillfully.