先天性肛门闭锁患儿行达芬奇机器人辅助肛门成形术的手术配合

Da Vinci robot assists surgical coordination of anal angioplasty in children with congenital anal atresia

目的总结9例先天性肛门闭锁患儿行达芬奇机器人辅助下肛门成形手术治疗的手术配合要点。方法对本院2016年10月至2017年10月9例先天性肛门闭锁患儿行达芬奇机器人辅助下肛门成形术,总结手术全过程和护理配合要点。结果9例患儿均在机器人辅助下完成手术,手术时间中位数116.4min,术中出血量中位数约42.3mL,术后恢复良好,均无相关并发症,术后6~15个月随访得肛门功能评分优良。结论使用达芬奇机器人系统辅助肛门成形手术需提前做好术前准备,对患儿进行全面地护理评估,采用相应的手术护理措施,术中做好体位护理,为患儿采取全程动态的综合保温措施,密切观察患儿生命体征的变化,重视手术无菌操作和洁污分区,熟练掌握达芬奇机器人的手术护理配合,其是保证手术顺利完成的关键。

Objective To summarize the key points of surgical coordination of 9 children with congenital anal atresia undergoing anal angioplasty with the assistance of Da Vinci robot.Methods Nine children with congenital anal atresia from October 2016 to October 2017 in our hospital underwent anal angioplasty with the assistance of Da Vinci robot,and summarized the whole operation and the main points of nursing cooperation.Results All the 9 children completed the operation with the assistance of robots.The average operation time was 116.4 minutes.The average blood loss during the operation was about 42.3 mL.The postoperative recovery was good and there were no related complications.The anal function score was excellent during follow-up 6 to 15 months.Conclusions The use of the Da Vinci robotic system to assist anal angioplasty can complete the protection of the pelvic floor nerves and external sphincter in a fine manner,which is promising in the direction of pediatric surgery.Well-preparedness in advance,comprehensive nursing assessments on the children,adoption of corresponding surgical nursing measures are key to ensurrance of the operation.