妇科机器人辅助腹腔镜手术初期并发症发生原因研究

Study on the causes of early complications in gynecological robot-assisted laparoscopic surgery

目的探讨妇科机器人辅助腹腔镜手术(简称机器人手术)初期并发症发生的原因及防治措施,以提高手术的安全性。方法对中国医科大学附属第一医院妇科2017年11月至2019年3月期间行机器人手术的218例患者的临床资料进行回顾性分析。结果机器人手术并发症17例,发生率为7.80%(17/218)。其中术中并发症13例(穿刺孔血肿、皮下气肿、外周神经损伤各3例,球结膜水肿2例,中心静脉导管脱出导致皮下水肿1例,阴道壁裂伤1例),术后并发症4例(穿刺孔延迟愈合1例,心肌缺血1例,精神症状1例,阴道裂伤1例)。结论妇科机器人手术并发症与术者及助手操作经验相关,术中术后需严密观察、及时纠正,并采取有效的预防措施以降低其发生率。

Objective To investigate the causes and preventive measures of early complications in gynecological robotic-assisted laparoscopic surgery(robotic surgery for short),in order to improve the safety of surgery.Methods The clinical data of 218 patients who underwent robotic surgery in the First Affiliated Hospital of China Medical University from November 2017 to March 2019 were retrospectively analyzed.Results The rate of complications was7.80%(17/218).There were 13 cases of complications during the operation(puncture hole hematoma,subcutaneous emphysema,peripheral nerve injury in 3 cases each,chemosis in 2 cases,subcutaneous edema caused by central venous catheter emergence in 1 case,vaginal wall laceration in 1 case),and there were 4 cases of postoperative complications(elayed healing puncture holes in 1 case,myocardial ischemia in 1 case,mental symptoms in 1 case,disruption of the vagina in 1 case).Conclusion The complications of gynecological robotic surgery are related to the operating experience of the operator and assistant.During and after surgery,close observation and timely correction should be made,and effective preventive measures should be taken to reduce the incidence.