达芬奇Xi手术机器人在肾部分切除术中手术入路选择的应用研究(附手术视频)

Application of Da Vinci Xi surgical system in partial nephrectomy with different surgical approaches(with surgical video)

目的:探讨达芬奇手术机器人辅助腹腔镜下肾部分切除术中不同手术入路选择的临床疗效及安全性,并为其临床应用提供经验。方法:回顾性分析2020年11月—2021年5月于新疆维吾尔自治区人民医院泌尿中心采用达芬奇Xi手术机器人行机器人辅助腹腔镜下T1期肾肿瘤肾部分切除术的23例患者临床资料。根据肿瘤部位与肾蒂的关系、腹部手术史、肥胖等因素,将所有患者分为经腹入路组(10例)和后腹膜入路组(13例),比较两种不同入路对围手术期的影响。结果:23例患者手术均顺利完成,术中未出现周围脏器及大血管损伤,无中转开放。比较不同手术入路发现,采用经后腹膜入路手术的装机速度及手术时间比经腹腔入路手术的时间显著缩短。结论:采用达芬奇Xi手术机器人行机器人辅助腹腔镜下肾部分切除术治疗肾肿瘤的疗效及安全性良好,且经后腹膜入路的手术方式效果更佳。

Objective:To investigate the clinical efficacy and safety of different surgical approaches in Da Vinci robotassisted laparoscopic partial nephrectomy,and to provide experience for its clinical application.Methods:The clinical data of 23 patients who underwent robot-assisted laparoscopic partial nephrectomy for T1 renal tumor using Da Vinci Xi surgical system in the Urology Center of Xinjiang Uygur Autonomous Region People’s Hospital from November 2020 to May 2021 were retrospectively analyzed.According to the relationship between tumor location and renal pedicle,history of abdominal surgery,obesity and other factors,all patients were divided into the transabdominal approach group(10 cases)and retroperitoneal approach group(13 cases),and the effect of two different approaches on the perioperative period was compared.Results:All the operations were successfully completed without conversion to open surgery.The operative time of retroperitoneal approach were significantly shorter than that of the transabdominal approach.Conclusion:The efficacy and safety of robot-assisted laparoscopic partial nephrectomy in the treatment of renal tumors with Da Vinci Xi surgical system are good,and the effect of retroperitoneal approach is better.