机器人食管裂孔疝修补联合胃底折叠术动物模型实验研究

Experimental study on an animal model of robotic esophageal hiatal hernia repair combined with fundoplication

目的探讨机器人食管裂孔疝修补联合胃底折叠术在猪动物模型实施的可行性和安全性。方法2022年3—4月在上海市直观复星创新中心实验室对3只猪行机器人食管裂孔疝修补联合胃底折叠术,胃底折叠手术方式包括Nissen(360°)、Toupet(240~270°)和Dor(180°)胃底折叠,每只猪在完成一种折叠方式后拆除缝线依次进行另2种折叠方式。记录术中情况、手术步骤、技术难点及注意事项等。结果术中动物生命体征均保持平稳,无中转开放手术,未发生术中大出血。Nissen胃底折叠手术时间为(150.3±20.7)min,Toupet胃底折叠手术时间为(155.0±25.7)min,Dor胃底折叠手术时间为(144.0±15.7)min,装机时间为5~15 min,拆机时间为5~10 min。出血量为(55.8±7.2)mL。术后恢复顺利,未发生死亡事件。结论在猪动物模型进行机器人食管裂孔疝修补联合胃底折叠手术安全可行,可为外科医师提供机器人手术系统缝合打结技术以及不同折叠术式的操作训练平台。

To explore the feasibility and safety of robotic esophageal hiatal hernia repair combined with fundoplication in a pig animal model.Methods From March to April 2022,three pigs were treated with robotic esophageal hiatal hernia repair combined with fundoplication.The fundoplication methods included Nissen fundoplication(360°),Toupet fundoplication(240-270°),and Dor fundoplication(180°).After one folding method,each pig removed the suture and performed another two folding methods in turn.Intraoperative conditions,surgical procedures,technical difficulties,and precautions were recorded.Results During the operation,the vital signs of the animals remained stable,and there was no conversion to open surgery and no intraoperative bleeding.The operation time of the Nissen fundoplication was(150.3±20.7)min,that of the Toupet fundoplication was(155.0±25.7)min,that of the Dor fundoplication was(144.0±15.7)min,that of installation was 5-15 min,and that of disassembly was 5-10 min.The amount of bleeding was(55.8±7.2)mL.The postoperative recovery was smooth,and no death occurred.Conclusion Robot-assisted repair of esophageal hiatal hernia combined with fundoplication in pig animal models is safe and feasible,providing surgeons with operation training opportunities.Surgeons can be more proficient in robot operation,esophageal hiatal hernia repair,gastric fundus folding operation steps,and suture skills.