论文部分内容阅读
目的探讨达芬奇机器人手术系统进行妇科肿瘤手术的临床价值。方法回顾性分析行达芬奇机器人手术11例妇科恶性肿瘤及19例妇科良性肿瘤患者与同期行腹腔镜手术的20例良性肿瘤患者及13例恶性肿瘤患者的手术情况,比较在手术时间、出血量、淋巴结清扫数量、术后短期并发症及中转开腹率的差异。结果达芬奇机器人手术系统在19例妇科良性肿瘤患者中平均手术时间(150±12)min,术中平均出血量(100±11.3)ml,无中转开腹,无切口感染、盆腔感染、皮下气肿、气胸等并发症;11例妇科恶性肿瘤患者中平均手术时间(270±6)min,平均出血量(120±10)ml,淋巴结清扫数量(25±5)枚,无中转开腹,无严重并发症。在术中出血量及淋巴结清扫数量优于腹腔镜手术,恶性肿瘤手术时间较腹腔镜手术时间延长,差异均有统计学意义(P<0.05)。结论达芬奇机器人手术系统是传统腹腔镜手术的升华,其高分辨的三维立体视觉、360°旋转的机械臂等优势为临床开展更精细、精确、复杂的手术提供了良好的保障。从传统腹腔镜手术过渡到机器人手术,穿刺点的位置选择需要注意个体化,适应机器人手术系统的能量器械,善于应用指尖及腕部的细微动作完成机器人手术系统的操作。
Objective To investigate the clinical value of Da Vinci robotic surgery system for gynecologic oncology. Methods Retrospective analysis of 11 cases of gynecological malignant tumors and 19 cases of gynecological benign tumors underwent Da Vinci robotic surgery with 20 cases of benign tumors and 13 cases of malignant tumors undergoing laparoscopic surgery in the same period were retrospectively analyzed. Volume, the number of lymph node dissection, postoperative short-term complications and transit laparotomy differences. Results The average operative time (150 ± 12) min, mean intraoperative blood loss (100 ± 11.3) ml, no laparotomy, pelvic infection, subcutaneous (270 ± 6) min, average blood loss (120 ± 10) ml and number of lymph node dissection (25 ± 5) in 11 cases of gynecologic malignancies without conversion to laparotomy, No serious complications. The amount of bleeding and the number of lymph node dissection were better than those of laparoscopic operation in operation. The operation time of malignant tumor was longer than that of laparoscopic operation, the difference was statistically significant (P <0.05). Conclusion DaVinci robotic surgery system is a sublimation of traditional laparoscopic surgery. The advantages of high resolution 3D stereo vision and 360 ° rotating robotic arm provide a good guarantee for more precise, precise and complicated surgery. From traditional laparoscopic surgery to robotic surgery, the choice of the location of the puncture point requires attention to individualization, adaptation of the robotic surgical system of energy instruments, and the application of fine movements of the fingertips and wrists to complete the robotic surgical system.