机器人单孔腹腔镜妇科手术7例分析及文献复习

目的初步探讨机器人单孔腹腔镜手术在妇科疾病应用中的安全性及可行性。方法回顾性分析2018年9月至2018年12月甘肃省人民医院7例妇科疾病患者行机器人单孔腹腔镜手术的临床资料,观察患者手术时间、术中出血量、术后首次排气时间、住院时间,并发症等指标。结果 7例患者年龄(36.29±7.98)岁,体重指数为(27.39±3.48)kg/m^2(≥24kg/m^2),属于超重患者。7例手术均成功完成,无中转开腹及增加辅助孔操作。平均手术时间(101.43±45.25)min,术中失血量(105.71±52.87)mL,术后首次通气时间(1.57±0.54)d,住院时间(3.71±1.38)d,均无并发症发生,术后随访美容效果满意。结论机器人单孔腹腔镜手术应用于妇科疾病安全可行,且更好地满足女性患者的美容需求,应用于超重甚至肥胖女性患者有更好的优势,但仍需大样本前瞻性、随机对照研究来验证其安全性及有效性。

Analysis of 7 cases of robot-assisted laparoendoscopic single-site gynecologic surgery and literature review

Objective To investigate safety and feasibility of robot-assisted laparoendoscopic single-site gynecologic surgery. Methods The clinical data of 7 patients who underwent robot-assisted laparoendoscopic single-site gynecologic surgery in Gansu Provincial People’s Hospital from September, 2018 to October, 2018 were analyzed retrospectively. The clinical indexes including operative time, intraoperative blood loss, time of first postoperative anal flatus, length of hospital stay, complications and so on of the patients were observed. Results The patients’ age was 36.29±7.98 years, and their BMI was 27.39±3.48 kg/m^2(≥24 kg/m^2), and they belong to overweight patients. All cases of robot-assisted laparoendoscopic gynecologic surgery were successfully completed without laparotomy and other auxiliary incisions. The mean operation duration was(101.43±45.25) min., the intraoperative blood loss was(105.71±52.87) mL, the time of first postoperative anal flatus was(1.57±0.54) days and the length of hospital stay was(3.71±1.38) days. Additionally, the postoperative follow-up revealed that the single-site procedure has a satisfactory esthetic effect. Conclusion Robot-assisted laparoendoscopic single-site surgery is safe and feasible for gynecological diseases, and it meets the cosmetic requirement of female patients better. Simultaneously, it has a better advantage for those overweight even obese female patients, but a large scale of prospective, randomized controlled studies are needed to verify its safety and effectiveness.