达芬奇机器人辅助乙状结肠癌外侧入路优先的定型化根治手术技术要点(附手术视频)

Key points of programmed radical surgery assisted by Da Vinci surgical robot via lateral approach for sigmoid colon cancer(with surgical video)

近年来,机器人辅助手术在胃肠外科的应用不断增加,机器人辅助结肠癌手术的安全性和可行性已在世界范围内得到验证。临床上,乙状结肠切除术的病例呈现多样化的特征,如严重粘连、结肠走行异常、乙状结肠过短需游离脾曲等,有时亦会碰到其他高难度病例。与传统腹腔镜手术相比,机器人辅助乙状结肠手术可降低中转开腹率,且在自主神经功能保护方面具有一定优势。尽管机器人辅助乙状结肠癌手术是安全、可行的,并且克服了传统腹腔镜手术的一些技术限制,但仍需对其手术操作流程进行定型化,以实现手术操作的同质化。本团队在完成50例机器人辅助乙状结肠癌手术的基础上,逐步优化操作流程,以期实现该术式的相对定型化。

In recent years,robot-assisted surgery has been widely used in gastrointestinal surgery.The safety and feasibility of robot-assisted surgery for colorectal cancer has also been demonstrated worldwide.With certain advantages,robotic surgery breaks some limitations of conventional laparoscopic surgery.The clinical profile of sigmoidectomy is diverse,such as severe adhesions,abnormal colonic alignment,short sigmoid colon requiring free splenic flexure,and other difficult cases.Compared with the conventional laparoscopic surgery,robot-assisted sigmoid colon surgery could reduce the rate of conversion to open surgery and protect autonomic function.Although it is safe,feasible and overcomes some of the technical limitations associated with conventional laparoscopic surgery,the procedure of robot-assisted sigmoid colon surgery still needs to be standardized to achieve homogeneity in performance.After 50 cases of robot-assisted sigmoid colon surgery,our team has progressively optimized the procedure,and the programmed steps to this procedure is initially achieved.