机器人辅助胰腺肿瘤切除术的护理配合

Nursing cooperation in robot-assisted pancreatic surgery for pancreatic cancer

目的:总结17例达芬奇机器人辅助下胰腺肿瘤切除术的配合要点。方法:选取2020年5月—2020年12月行达芬奇机器人辅助下胰腺肿瘤切除术的17例患者。手术配合护士通过达芬奇机器人培训合格后再经专科组培训,具备高专业的胰腺手术配合技术和机器人手术相关的知识技能。通过充分的术前准备和默契的术中配合,及时有效地处理机器人手术中常见的问题和故障。结果:15例手术均在机器人辅助下顺利完成,2例患者因血管破裂出血紧急转为腹腔镜手术并安全完成手术。平均术中出血量为(232.3±253.2)ml,平均手术时间为(352.1±143.9)min。所有患者未见术中压力性损伤、皮下气肿等并发症。结论:达芬奇机器人辅助胰腺肿瘤切除术手术时间相对较长、步骤复杂、风险相对较高,配合护士在具备腹腔镜胰腺手术配合技能的同时,还应掌握机器人手术相关的知识技能,从传统手术护理配合中找出机器人手术配合的关键点,以确保手术安全顺利完成。

Objective:To summarize the key points of collaboration in nursing from 17 cases of robot-assisted pancreatic surgery for pancreatic cancer.Methods:A total of 17 patients underwent Da Vinci robot-assisted pancreatic surgery for pancreatic cancer in the Affiliated Hospital of Xuzhou Medical University from May 2020 to December 2020 were selected.After passing the basic Da Vinci robotic surgery training,surgical nurses were further trained by the selected surgical specialists and acquired professional nursing and collaboration skills.The selected surgical nurses could skillfully and correctly deal with the common issues or failures in robot-assisted pancreatic surgery based on sufficient preoperative preparation and smooth cooperation during surgery.Results:15 cases of Da Vinci robot-assisted pancreatic surgery were successfully and safely completed.2 cases of conversion to laparoscopy due to extensive vascular rupture with bleeding.All the 17 cases had no major complications such as pressure injury or subcutaneous emphysema.The mean intraoperative bleeding was(232.3±253.2)ml and the average operative time was(352.1±143.9)min.Conclusion:Da Vinci robot-assisted pancreatic surgery for pancreatic cancer is relatively high risk due to its long operative time and complex procedures,which requires high proficiency and specialization on surgical nurses.It is required that surgical nurses should master cooperating skills in robot-assisted pancreatic surgery and find out the specificities of nursing in robotic surgery compared to the traditional surgery to ensure the surgery done safely.