新型国产腔镜机器人在前列腺根治术中的医护配合探讨

Surgical cooperation of the new domestic endoscope robot for radical prostatectomy

目的探讨"图迈TM"机器人实施前列腺根治切除术的手术护理配合方法。方法通过对19例国产腹腔内窥镜手术系统-"图迈TM"机器人前列腺切除术的手术配合和临床效果进行分析,提出手术室护士术中配合的具体要点,建立"图迈TM"机器人手术配合流程。结果入组患者均顺利完成手术,无中转开放手术或更改为普通腹腔镜手术。本组患者平均术前准备时间(34±4)min,平均出血量(98±4)ml,平均手术时间(214±62)min,均未发生24 h内二次手术,并且均未出现因用物准备不充足,手术配合不熟练,手术衔接过程不流畅等问题造成手术时间延长的现象。医护配合满意度和患者满意度分别为95%和96%,本组患者在术后均未出现Clavien-Dindo≥Ⅲ级或与护理相关的并发症,患者排尿功能均有改善,平均肛门排气时间(2.3±0.6)d,平均疼痛评分(5.3±1.1)分,平均住院时间(4.7±3.5)d。结论在新型国产机器人辅助前列腺根治术中,护理团队充分的术前准备和体位管理、流程化的配合与优化的头部空间管理有利于手术配合,保障了手术的顺利进行和患者的安全,值得广泛推荐运用。

Objective To explore the cooperative method of surgical nursing for radical prostatectomy with"TumaiTM"robot.Methods Through the analysis of surgical cooperation and clinical effect of 19 cases of prostatectomy with"TumaiTM"robot,the specific points of intraoperative cooperation of nurses in the operating room were put forward,and the surgical cooperation process of"TumaiTM"robot was established.Results All the enrolled patients were completed the surgeries successfully,without transferring to open surgery or changing to ordinary laparoscopic surgery.In this group,the average preoperative preparation time was(34±4)min,the average blood loss was(98±4)ml,and the average operation time was(214±62)min.No second operation occurred within 24 h.In addition,the operation time was not prolonged due to inadequate preparation of materials,unskilled operation coordination,or uneven operation cohesion process.The satisfaction of surgical cooperation and patients were 95% and 96% respectively.In this group,no clavien-Dindo≥Ⅲ or nursing related complications occurred after surgery.The urination function of the patients was improved,the average anal exhaust time was(2.3±0.6)d,and the average pain score was(5.3±1.1)points.The mean hospital stay was(4.7±3.5)d.Conclusions In the new domestic robot-assisted radical prostatectomy,the nursing team's adequate preoperative preparation,posture management,process coordination and optimized head space management are conducive to surgical coordination and ensure the smooth operation and patients'safety,which is worth widely recommended.