机器人低位直肠癌前切除手术的要点和经验

The key point and experience of robotic low anterior resection for rectal cancer

相较于传统腹腔镜技术,手术机器人因其更精细的操作在低位直肠癌手术中应用越来越广泛。作者分享了机器人低位直肠癌前切除手术的要点和经验,提出机器人直肠癌手术要注意Trocar布局及机器人安装,合理利用器械臂进行直肠游离、淋巴结清扫及消化道重建;应注重双吻合技术操作中的细节,腔内直线切割闭合器和圆形吻合器使用过程中注意"停顿",修整"蘑菇头",去除多余组织,避免浆膜外溢;吊角缝合技术可对吻合口区域的"猫耳朵"及"危险三角"进行加强,降低吻合口瘘的发生率。

Compared with traditional laparoscopic technology,robotic surgery has been widely used in low rectal cancer due to its dexterity and ambidextrous capability.Robotic surgery should pay attention to trocar arrangement,robot installation,rational use of instrument arms for rectum,lymphatic dissection and digestive tract reconstruction.we should pay more attention to double stapling technique anastomosis.Using Endo-GIA and Circlur stapler need to“pause”during the operation,removing excess tissue in the proximal intestine and avoiding serosal overflow.Reinforcing sutures for“dog-ears”and“risk triangle”can reduce the incidence of anastomotic leakage.This technique was simple and practical,and worth popularizing.