[1]骆明双 高贺云 易跃雄① 张蔚① 郭云凯 余山桢 张欣 张文**.达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变[J].中国微创外科杂志,2024,01(4):278-282.
　Luo Mingshuang*,Gao Heyun*,Yi Yuexiong,et al.Application of da Vinci Robot Xi Systemassisted Singleincision Laparoscopic Surgery in the Treatment of Benign Ovarian Lesions in Children and Adolescents[J].Chinese Journal of Minimally Invasive Surgery,2024,01(4):278-282.
点击复制

达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年4期
页码:
278-282
栏目:
短篇论著
出版日期:
2024-04-25

文章信息/Info

Title:
Application of da Vinci Robot Xi Systemassisted Singleincision Laparoscopic Surgery in the Treatment of Benign Ovarian Lesions in Children and Adolescents
作者:
骆明双 高贺云 易跃雄① 张蔚① 郭云凯 余山桢 张欣 张文**
(武汉大学中南医院小儿外科，武汉430071)
Author(s):
Luo Mingshuang*;  Gao Heyun*;  Yi Yuexiong;  et al.
*Department of Pediatric Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
关键词:
达芬奇机器人; 儿童; 青少年; 单孔腹腔镜; 卵巢良性病变
Keywords:
da Vinci Robot; Children; Adolescents; Singleincision laparoscopy; Benign ovarian lesions
文献标志码:
A
摘要:
目的探讨达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的效果。方法2020年 6月~2023年3月我院行达芬奇机器人Xi系统辅助单孔腹腔镜下卵巢良性病变剔除术13例，采用特制4通道单孔腹腔镜装置，完成达芬奇机器人与患者的对接，使用不带能量的剪刀切开病变卵巢并暴露肿瘤组织，沿肿瘤边缘尽可能完整地剔除肿瘤组织，可吸收线封闭创面后，复原脐部结构。结果13例均通过脐部单一切口完成卵巢良性病变剔除术，无中转开腹。手术时间81~246 min，平均161.4 min。术中出血量5~50 ml，平均21.2 ml。术中发现卵巢扭转2例，卵巢良性病变破裂3例（术后放置引流管）。术后病理：9例成熟畸胎瘤，2例浆液性囊腺瘤，2例单纯性囊肿。术后住院时间2~7 d，平均4.2 d。1例术后切口感染，抗生素治疗后治愈。13例随访6~36个月，平均21.1月，无肿瘤复发，无并发症发生，所有患者脐部切口瘢痕隐匿，且患者及家属对术后外观均满意。结论达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变安全、可行，可作为一种治疗卵巢良性病变的选择。
Abstract:
ObjectiveTo explore the effectiveness of da Vinci Robot Xi systemassisted singleincision laparoscopic surgery for treating benign ovarian lesions in children and adolescents. MethodsFrom June 2020 to March 2023, 13 cases of benign ovarian lesions were operated by using a specially designed 4channel singleincision laparoscopic device assisted by the da Vinci Robot Xi system. The docking between the da Vinci Robot and the patient was completed, and the affected ovaries were cut open with a nonpowered scissors to expose the tumor tissue. The tumor tissue was removed as completely as possible along the edge of the tumor, and an absorbable suture was used to seal the wound followed by restoring the umbilical structure.Results All the 13 cases underwent ovarian benign lesion resection through a single incision in the umbilical region, without conversion to open surgery. The surgical time was 81-246 min, with an average of 161.4 min. The intraoperative bleeding volume was 5-50 ml, with an average of 21.2 ml. During the operation, 2 cases of ovarian torsion and 3 cases of ovarian benign lesion rupture (with postoperative drainage tube placement) were found. Postoperative pathological findings showed 9 cases of mature teratoma, 2 cases of serous cystadenoma, and 2 cases of simple cyst. The postoperative hospitalization time was 2-7 d, with an average of 4.2 d. There was 1 case of postoperative incision infection who was cured after antibiotic treatment. The followup period was 6-36 months, with an average of 21.1 months. No tumor recurrence or complications occurred, and all the patients had hidden scars on the umbilical incision. The patients and their families were satisfied with the postoperative appearance.ConclusionThe application of da Vinci Robot Xi systemassisted singleincision laparoscopic surgery in the treatment of benign ovarian lesions in children and adolescents is safe and feasible, which can be considered as an option for treating such conditions.

参考文献/References:

[1]AI Jama FE, Al Ghamdi AA, Gasim T, et al. Ovarian tumors in children and adolescents-a clinical study of 52 patients in a university hospital. J J Pediatr Adolesc Gynecol,2011, 24(1):25-28.
[2]Lawrence AE, Minneci PC, Deans KJ. Ovarysparing surgery for benign pediatric ovarian masses. Curr Opin Pediatr,2019,31(3):386-390.
[3]Litz C, Danielson PD, Chandler NM. Single incision laparoscopic surgery for pediatric adnexal pathology. J Pediatr Surg,2014,49(7):1156-1158.
[4]张军,魏延栋,刘树立,等.腹腔镜与开腹手术在卵巢囊肿剔除术中的对比研究.中华小儿外科杂志,2019,40(2):133-136.
[5]Akdemir A, Yildirim N, Zeybek B, et al. Single incision transumbilical total hysterectomy: robotic or laparoscopic? Gynecol Obstet Invest,2015,80(2):93-98.
[6]Mei H, Tang S. Roboticassisted surgery in the pediatric surgeons’ world: Current situation and future prospectives.Front Pediatr,2023,11:1120831.
[7]Nakib G, Calcaterra V, Scorletti F, et al. Robotic assisted surgery in pediatric gynecology: promising innovation in mini invasive surgical procedures.J Pediatr Adolesc Gynecol,2013,26(1):e5-e7.
[8]Amies Oelschlager AM, Gow KW, Morse CB, et al. Management of large ovarian neoplasms in pediatric and adolescent females. J Pediatr Adolesc Gynecol,2016,29(2):88-94.
[9]赵晶,王海琳,孙亮亮,等.达芬奇机器人Xi系统辅助单孔腹腔镜手术在妇科良性疾病中的应用分析.机器人外科学杂志(中英文),2023,4(4):343-349.
[10]Zhang M, Jiang W, Li G, et al. Ovarian masses in children and adolescents-an analysis of 521 clinical cases. J Pediatr Adolesc Gynecol,2014,27(3):e73-e77.
[11]uczak J, Bagaj M. Selecting treatment method for ovarian masses in children-24 years of experience. J Ovarian Res,2017,10（1）：59.
[12]Seckin B, Ozdener T, Tapisiz OL, et al. Laparoscopic treatment of ovarian cysts in adolescents and young adults. J Pediatr Adolesc Gynecol,2011,24(5):300-303.
[13]Laberge PY, Levesque S. Shortterm morbidity and longterm recurrence rate of ovarian dermoid cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can,2006,28(9):789-793.
[14]Mizuno K, Kojima Y, Nishio H, et al. Robotic surgery in pediatric urology: current status. Asian J Endosc Surg,2018,11(4):308-317.
[15]Navarrete Arellano M, Garibay González F. Robotassisted laparoscopic and thoracoscopic surgery: prospective series of 186 pediatric surgeries. Front Pediatr,2019,7:200.
[16]MoralesLópez RA, PérezMarchán M, Pérez Brayfield M. Current concepts in pediatric robotic assisted pyeloplasty. Front Pediatr,2019,7:4.
[17]Hassan SO, Dudhia J, Syed LH, et al. Conventional laparoscopic vs robotic training: which is better for naive users? A randomized prospective crossover study. J Surg Educ,2015,72(4):592-599.
[18]Uccella S, Casarin J, Marconi N, et al. Laparoscopic versus open hysterectomy for benign disease in women with giant uteri (≥1500 g): feasibility and outcomes. J Minim Invasive Gynecol,2016，23（6）：922-927.
[19]郭楠,倪观太,丁锦,等.经脐单孔腹腔镜卵巢囊肿手术.中国微创外科杂志,2019,19(6):515-517,522.
[20]Nelson RJ, Chavali JSS, Yerram N, et al. Current status of robotic singleport surgery. Urol Ann,2017,9(3):217-222.
[21]Xu D, Gao H, Yu S, et al. Ensuring safety and feasibility for resection of pediatric benign ovarian tumors by singleport robotassisted laparoscopic surgery using the da Vinci Xi system. Front Surg,2022,9:944662.
[22]Liu H,Wang X,Lu D,et al. Ovarian masses in children and adolescents in China: analysis of 203 cases. J Ovarian Res,2013,6:47.

备注/Memo

备注/Memo:
基金项目：武汉大学中南医院学科能力建设项目（YYXKNLJS2024020）**通讯作者，Email:wzhang115@163.com ①妇科
更新日期/Last Update: 2024-07-02