机器人手术系统辅助妇科手术60例报告

目的:探讨达芬奇机器人手术系统辅助妇科手术的安全性及可行性。方法:回顾分析2009年2月至2012年5月为60例患者行达芬奇机器人手术系统辅助妇科手术的临床资料。结果:9例行子宫内膜癌分期手术,8例行全子宫切除术,1例行子宫次全切除术,26例行子宫肌瘤切除术,10例行子宫内膜异位症手术,2例行卵巢肿瘤手术,4例行宫颈癌根治术;其中2例中转开腹。手术时间平均(132.22±40.42)min,术中出血量平均(136.58±60.14)ml,术后肠蠕动恢复时间平均(23.6±13.4)h,术后平均住院(8.2±5.1)d。术后1例发生不全肠梗阻,怀疑脏器穿孔,再次经腹腔镜探查未发现异常,余者均无并发症发生。结论:达芬奇机器人手术系统应用于妇科领域安全、可行,但要求术者不仅要熟悉盆腔解剖结构,具有丰富的开腹手术经验,而且应具备娴熟的腹腔镜技术,术中遇意外情况可妥善处理。

The application of Da vinci robot-assisted gynecological surgery: with a report of 60 cases

Objective: To investigate the safety and feasibility of the Da vinci robot-assisted gynecologic surgery.Methods: The clinical data were reviewed retrospectively in 60 patients undergoing robotic surgery with the da Vinci surgical system from Feb.2009 to Feb.2012.Results: These robot-assisted gynecologic procedures including 9 endometrial carcinoma staging surgery,8 total hysterectomy,1 subtotal hysterectomy,26 uterine myoma enucleation,10 endometriosis surgery,2 ovarian tumor,4 cervical carcinoma radical hysterectomy were accomplished successfully.The mean operation time was(132.22 ± 40.42) min,and the mean intra-operative blood loss was(136.58 ± 60.14) ml.The mean postoperative bowel recovery time was(23.6 ± 13.4) h and the mean postoperative hospital stay time was(8.2 ± 5.1) d.One case experienced postoperative incomplete intestinal obstruction was explored by laparoscopy because of suspicious organ perforation,but there was no abnormality.There were no postoperative complications in the other cases.Conclusions: Robot-assisted gynecological surgery is safe and feasible.The surgeons should master the anatomy of the pelvic cavity,have skilled experiences of laparotomy,and master the laparoscopic technique skillfully.