临床外科杂志 ›› 2023, Vol. 31 ›› Issue (5): 419-422.doi: 10.3969/j.issn.1005-6483.2023.05.006

• 论著 • 上一篇    下一篇

单孔机器人技术在婴幼儿泌尿系手术中的应用

  

  1. 430071  武汉大学中南医院小儿外科(黄光彬、李庚、高贺云、郭云凯、余山桢、胡涛、杜国伟、张文),麻醉手术科(向梦、宋学敏),泌尿外科(杨琨)
  • 收稿日期:2023-03-16 修回日期:2023-03-16 出版日期:2023-05-20 发布日期:2023-05-20
  • 通讯作者: 张文,Email:wzhang115@163.com

Application of single-port robotic technology in urological surgery of infants

  1. Department of Pediatric Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China
  • Received:2023-03-16 Revised:2023-03-16 Online:2023-05-20 Published:2023-05-20

摘要: 目的 探讨达芬奇Xi系统辅助单孔腹腔镜技术在婴幼儿泌尿系手术中的应用价值。方法 2020年8月~2022年10月本中心单孔机器人术后随访超过半年的婴幼儿18例;肾盂成形术11例(1例双侧肾盂成形术);输尿管输尿管吻合术3例;Lich-Gregoir术1例;发育不良肾切除术2例;前列腺囊切除术1例;18例中合并有内环口未闭者9例(双侧内环口未闭3例),总结技术操作体会及随访治疗效果。结果 18例患儿均通过脐部单一切口顺利完成手术,无中转开腹;术后住院(7.9±3.8)天,随访(16.3±8.6)个月;术后出现吻合口漏尿1例,引流9天后自愈拔管;术后2周出现尿路感染1例,口服抗生素治愈后未复发;无中远期并发症;手术切口愈合良好,无感染、瘢痕增生及切口疝等并发症,患儿家属对术后外观均满意。结论 通过达芬奇Xi系统辅助单孔机器人技术进行婴幼儿泌尿系手术可行,虽具有一定的技术难度,但能获得更好的微创及美容效果。

关键词: 单孔机器人手术, 婴幼儿, 肾盂成形术, 输尿管-输尿管吻合术, 前列腺囊

Abstract: Objective To explore the application value of single-port robotic surgery in infant urological surgery by using the Da Vinci Xi system.Methods From August 2020 to October 2022,18 infants who underwent single-port robotic surgery in our center with at least 6 months’ follow-up were selected.11 cases completed pyeloplasty,including 1 case of bilateral pyeloplasty;3 cases underwent uretero-ureteral anastomosis;1 case followed Lich-Gregoir technique;2 cases underwent nephrectomy of renal hypoplasia;1 case underwent capsulectomy of the prostate;9 in 18 cases were combined with patent processus vaginalis,including 3 cases with bilateral patent processus vaginalis;The operating experience and follow-up treatment effect were analyzed.Results All 18 children successfully completed the operation without converting to laparotomy through a single incision under the umbilicus;the postoperative hospital stay was (7.9±3.8 )days,and the postoperative follow-up was (16.3±8.6 )months.1 case occurred anastomotic leakage after the operation,and it was cured after the drainage tube was used for 9 days;1 case developed urinary tract infection 2 weeks after the operation,and was cured after taking antibiotics without recrudescence;there was no mid-and-long-term complications;the surgical incision healed well,and there were no complications such as infection,scar proliferation or incisional hernia.Postoperative appearance satisfaction was great.Conclusion It is feasible to perform urological surgery on infants through single-port robotic technology using the Da Vinci Xi system.Although it exists certain technical difficulties in application,it can bring better minimally invasive experience and cosmetic effect for infants.

Key words: single-port robotic surgery, infants, pyeloplasty, uretero-ureteral anastomosis, cyst of prostate

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