国内首次运用第三代da Vinci Si普通器械结合单孔平台进行妇科肿瘤手术20例分析与探讨

Analysis and discussion of using the third generation da Vinci Si common instruments combined with single-port laparoscopy platform on 20 cases of gynecological tumor surgery

目的探讨第三代da Vinci Si机器人手术系统普通器械结合单孔平台在妇科肿瘤手术应用中的安全性和可行性。方法自2018年6月1日至2019年2月28日,上海长征医院运用第三代da Vinci Si机器人普通器械结合单孔平台实施20例妇科肿瘤手术(包括广泛性全子宫及双侧附件切除术,盆腔前哨淋巴结切除术,盆腔淋巴结切除术,腹主动脉旁淋巴结活检术等)。观察术中情况、术后恢复和随访情况。结果运用第三代da Vinci Si机器人手术系统普通器械结合单孔平台均手术顺利,无一例中转开腹,平均手术时间236.25 min,术中平均出血量约173 mL,术中均无输血。术后平均出院时间8 d,随访3个月术后均无并发症发生,为无瘤生存期。结论第三代da Vinci Si机器人手术系统普通器械结合单孔平台治疗妇科肿瘤是安全可行的。

Objective To explore the safety and feasibility of the third generation da Vinci Si robotic surgical system s common instruments combined with single-port laparoscopy platform in gynecological tumor surgery.Methods From June 1,2018 to February 28,2019,Shanghai Changzheng Hospital had operated 20 cases of gynecological tumor surgery using the third generation of da Vinci Si robotic surgical system s common instruments combined with single-port laparoscopy platform(including total extensive hysterectomy and bilateral adnexectomy,pelvic sentinel lymph node resection,pelvic lymph node cleaning operation,abdominal aorta beside lymph node biopsy operation,etc.).The operation,postoperative recovery and follow-up information of patients were observed.Results The operations were successfully completed by using the third generation of da Vinci Si robotic surgical system s common instruments combined with single-port laparoscopy platform.None of them need to be changed to open abdomen operation.The average operation time is 236.25 min,the average hemorrhage volume is about 173 mL and there was no blood transfusion during the operation.The average postoperative discharge time is 8 days,and no postoperative complications were observed during the 3-month follow-up,indicating tumor-free survival.Conclusions The operation using the third generation da Vinci Si robotic surgical system s common instruments combined with single-port laparoscopy platform in gynecological tumor surgery is safe and feasible.