运用国产单孔机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经验(附视频)

Primary experience of a domestic single-port robotic surgical system in retroperitoneal adrenalectomy(with video)

目的:探讨运用国产“术锐”单孔蛇形臂机器人手术系统完成腹膜后入路单孔肾上腺切除术的初步经验。方法:南京医科大学第二附属医院泌尿外科于2021年11月—2021年12月收治的4例肾上腺肿瘤患者,运用国产“术锐”单孔蛇形臂机器人手术系统完成单孔肾上腺切除术,手术均采用经腹膜后入路,记录肿瘤大小、手术时间、术中出血量等信息,并对围手术期资料、手术并发症及术后恢复情况进行分析。结果:4例患者中男女各2例,年龄40~68岁,平均年龄54岁,平均BMI值为26.2(24.8~29.8)kg/m^(2);肿瘤最大直径1.2~3.3 cm,其中左侧1例,右侧3例;4例手术均采用纯单孔方式,术中均未增加辅助通道,手术总时间104~200 min,机器人操作时间50~96 min,术中出血量10~50 ml。术后病理诊断为肾上腺皮质腺瘤3例,右血管内乳头状内皮细胞增生(Masson瘤)1例。术后均未出现出血、发热、切口感染等并发症。结论:运用“术锐”单孔蛇形臂机器人手术系统可安全、有效地完成腹膜后入路单孔肾上腺切除术,蛇形臂具有动作灵活、指向性准确等优势,可保障手术的顺利实施。

Objective:To explore the surgical experience of domestic single-port robotic surgical system(Single-port surgical robot with sneak-like arms,Beijing Surgerii Robotics Co.,Ltd)in retroperitoneal adrenalectomy.Methods:4 patients who were scheduled for adrenalectomy due to adrenal neoplasm in the Department of Urology of the Second Affiliated Hospital of Nanjing Medical University from Nov.2021 to Dec.2021 were selected as the research objects.Domestic single-port robotic surgical system was used to perform single-port adrenalectomy on the 4 patients with retroperitoneal approach.Clinical data on tumor size,operative time,intraoperative blood loss was recorded,and perioperative data,surgical complications and postoperative recovery were analyzed.Results:4 patients(2 male and 2 female)with a mean age of 54 years(40 to 68 years)and a mean BMI of 26.2(24.8 to 29.8)kg/m^(2).The tumors ranged from 1.2 to 3.3 cm in maximum diameter,including 1 case of left side and 3 cases of right side.The 4 cases of surgeries were all performed under single-port without extra auxiliary channels,and the total operative time ranged from 104 to 200 min,while the robotic operative time ranged from 50 to 96 min,with the intraoperative blood loss of 10 to 50 ml.Adrenocortical adenoma was confirmed in 3 patients and papillary endothelial cell hyperplasia(Masson’s tumor)within the right vessel in 1 patient by postoperative pathological diagnosis.There were no complications such as bleeding,fever,and incision infection found in the postoperative period.Conclusion:With the advantages of flexible movement and accurate operation of serpentine arms,retroperitoneal adrenalectomy could be safely and effectively performed with the domestic single-port robotic surgical system.