新技术新方法

国产单孔手术机器人辅助腹腔镜下肾部分切除术的可行性及安全性分析

  • 罗城 ,
  • 郭胜杰 ,
  • 张志凌 ,
  • 周芳坚
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  • 中山大学肿瘤防治中心泌尿外科 (广州 510000 )

收稿日期: 2023-11-10

  网络出版日期: 2024-01-10

基金资助

广东省重点领域研发计划资助项目(2020B1111140002)

Feasibility and safety analysis of domestic single-port robot system-assisted laparoscopic partial nephrectomy

  • Cheng LUO ,
  • Shengjie GUO ,
  • Zhiling ZHANG ,
  • Fangjian. ZHOU
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  • Department of Urology,Sun Yat?Sen Univertity Cancer Center,Guangzhou 510000,China

Received date: 2023-11-10

  Online published: 2024-01-10

摘要

目的 研究国产单孔手术机器人辅助内窥镜系统行肾部分切除术的可行性,并根据实验结果分析其用于临床肾部分切除手术的安全性。 方法 选取3只符合条件的实验用猪,由高级职称泌尿外科医生(2名)和高年住院医生(1名)分别用国产单孔手术机器人分别对其进行左右肾部分切除手术,并记录手术时长、热缺血时长、缝合时间、估计失血量、切除肾实质的体积等数据。 结果 3只实验猪,12次肾部分切除手术均能在单孔下顺利完成手术。其中楔形切除8次(楔形切除组),半肾切除4次(半肾切除组)。楔形切除肾脏体积(7.35 ± 0.81)mL,失血量(8.50 ± 11.09)mL。总手术时长(41.67 ± 8.50)min,其中切除时间(5.88 ± 3.27)min,缝合时间(11.75 ± 2.82)min。半肾切除肾脏体积(24.30 ± 2.18)mL,失血量(6.25 ± 4.35)mL。手术时长(47.00 ± 11.27)min,其中切除时间(3.25 ± 1.50)min,缝合时间(10.00 ± 5.25)min。所有手术松开动脉止血夹后创面未见出血。半肾切除组手术时间、出血量与楔形切除组相比无显著差异;高级职称医生组手术时间、出血量与高年住院医生组相比也无显著差异。运用NASA-TLX测量表用于评估术者在手术操作时的工作负荷程度,结果显示3名医生受挫程度都不高。术中均未发生与单孔手术机器人相关的不良事件。 结论 国产单孔手术机器人行肾部分切除手术是安全可行的。

本文引用格式

罗城 , 郭胜杰 , 张志凌 , 周芳坚 . 国产单孔手术机器人辅助腹腔镜下肾部分切除术的可行性及安全性分析[J]. 实用医学杂志, 2023 , 39(24) : 3275 -3280 . DOI: 10.3969/j.issn.1006-5725.2023.24.022

Abstract

Objective To study the feasibility of domestic single-port surgical robot assisted endoscopic system for partial nephrectomy, and analyze its safety in clinical partial nephrectomy based on experimental results Methods Three qualified experimental pigs were selected, two senior urological professors and a senior resident doctor used a domestic single-port surgical robot to perform partial nephrectomy on the left and right kidneys. Recorded the operation duration, hot ischemia duration, suture time, estimated blood loss, volume of renal parenchyma excision and other information. Results There were 8 wedge resection and 4 heminephrectomies. The kidney volume of wedge resection was (7.35 ± 0.81)mL and the blood loss was (8.50 ± 11.09)mL. The total operation time was (41.67 ± 8.50)min, and the time of resection was (5.88 ± 3.27)min and the stitching time was (11.75 ± 2.82)min. The kidney volume of heminephrectomy was (24.30 ± 2.18)mL, and the blood loss was (6.25 ± 4.35)mL. The total operation time of heminephrectomy was (47.00 ± 11.27)min, and the time of resection was (3.25 ± 1.5)min and the stitching time was (10.00 ± 5.25)min. No bleeding was observed on the wound after the Bull dog was released in all operations. There was no significant difference in operation time and blood loss between the heminephrectomy group and the wedge resection group. There was no significant difference in operation time or blood loss between the senior doctor group and the senior resident doctor group. The NASA-TLX scale was used to assess the degree of workload of the operator during surgical operations, and the results showed that none of the three surgeons had a high level of frustration.There were no adverse events related to the single-port surgical robot system during the operation. Conclusion It is safe and feasible for a domestic single-port surgical robot system to perform a partial nephrectomy.

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