达芬奇机器人在胆总管囊肿手术切除中的应用

Application of da Vinci surgical system for surgical resection of choledochal cysts

目的评估达芬奇机器人手术系统辅助胆总管囊肿切除术的安全性及疗效,总结手术经验。方法回顾性分析2016年3月至2018年12月于中山大学附属第一医院胆胰外科接受达芬奇机器人辅助胆总管囊肿切除术的12例患者临床资料,分析其相关的临床数据,评估手术的安全性及近期疗效。结果12例均顺利完成机器人辅助下胆总管囊肿及胆囊切除、肝管空肠改良襻式吻合术;手术中位时间为385min(280~420min),术中出血量中位数为30ml(30~100ml)。3例有腹腔手术史患者术后进食时间、住院时间与无手术史的患者比较,差异无统计学意义。术后1例患者发生腹腔感染,经保守治疗后痊愈;术后平均住院(7.7±1.4)d,无一例30d内再入院。结论达芬奇机器人辅助胆总管囊肿切除手术安全、可靠,操作更精准灵活、舒适,具有微创、术中出血少、术后恢复快的优势。

Objective To evaluate the safety and efficacy of da Vinci robot surgery system in assisting choledochal cyst resection,and summarize the experience of surgery.Methods From March 2016 to December 2018,the clinical data of twelve patients with choledochal cysts,who underwent surgical resection assisted by da Vinci robot surgery system in the First Affiliated Hospital of Sun Yatsen University were retrospectively analyzed to evaluate the safety and short-term efficacy of the operation. Results Robotic-assisted resection of choledochal cysts,gallbladder and modified looped hepaticojejunostomy were successfully performed on all 12 patients.The median operation time was 385 min (280- 420 min),the median intraoperative blood loss was 30 ml (30-100 ml).There were no significant differences in feeding time or hospitalization time between 3 patients with history of abdominal surgery and those without history of surgery.Postoperatively,one patient suffered from intra-abdominal infection,which was cured by conservative treatment later.All patients were discharged with a post-operative hospital stay of (7.7±1.4) d.No patient re-admitted within 30 days.Conclusions Da Vinci robot surgery system in assisting choledochal cyst resection is safe and reliable procedure,with advantages of minimal invasion,less intraoperative blood loss,and faster recovery.The surgeons can finish more precise movements comfortably.