附属第一医院手术室,广东,广州,510080
网络首发:2017-05-06,
纸质出版:2017
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陈育贞, 曾庆兵, 陈小俊, 等. 达芬奇机器人系统应用于小儿肾积水的术中配合体会[J]. 中山大学学报(医学科学版), 2017,38(3).
Application of Da Vinci Robot System in Pediatric Hydronephrosis[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(3).
【目的】探讨达芬奇机器人系统应用在小儿肾积水离断式肾盂输尿管整形术中的作用,提高手术效果,有效缩 短手术时间。【方法】对2015年11月至2016年7月在我院完成的14例(16侧)小儿肾积水患儿实施达芬奇机器人辅助离断 式肾盂输尿管整形术的术中配合,包括:术前宣教、器械物品准备充分,并确保机器人系统的正常运转;术中做好有效的体 位安置及患儿安全保护,无菌屏障的建立;术后机器人的保养与维护等进行总结与分析。【结果】14例(16侧)小儿肾积水患 儿手术均经腹膜腔完成。Docking时间由40 min缩短为20 min,手术操作时间(115±38)min。术后1例患者出现吻合口狭 窄,经PCN肾镜下吻合口扩张无效,半年后开放手术重新行肾盂输尿管吻合后治愈。余患儿均吻合口通畅,恢复良好,手术 成功率93.75%。术中未出现由于配合不当引起机器人故障及护理不当出现的并发症。【结论】达芬奇机器人辅助离断式肾 盂输尿管整形术治疗小儿肾积水手术创伤小,手术时间短,效果好。充分的术前准备,医护人员正规的专业技术培训及专 业的合作团队,不仅能提高手术效率,而且也是确保手术成功的关键。
【Objective】To explore the application of Da Vinci robot in laparoscopic pyeloplasty treatment for pediatric hydrone? phrosis and to improve the effect of operation and shorten the operation time effectively.【Methods】A summary and analysis was per? formed on the intraoperative cooperation about the clinical data of 14 pediatric hydronephrosis cases(16 sides)whom were performed RALP from November 2015 to July 2016. The intraoperative cooperation includes preoperative education,adequate preparation of surgical instruments,ensuring the normal operation of robot system before surgery and also,the proper body positions,the protection for patients,the establishment of aseptic barrier during operation as well as the maintenance of robot after operation.【Results】All procedures were performed via transperitoneal approach. Docking time was shortened from 40 to 20 min,operation time lasted(115± 38)min. One severe case presented with anastomasis stenosis even after PCN dilatation,and was redid dismembered pyeloplasty half a year later and the ultimate result was good. The other cases recovered well and the overall success rate was 93.75%. There were no robot failure caused by improper cooperation and no complications caused by improper nursing among the 14 pediatric hydronephrosis cases(16 sides)in pediatric hydronephrosis operations.【Conclusion】Da Vinci robot performed well in assisting laparoscopic pyelo? plasty treatment for pediatric hydronephrosis,for it leaves light surgical trauma and short duration of operation. Adequate preoperative preparation,medical staff’s formal professional technical training and professional cooperation team can not only improve the opera? tion efficiency,but also be the key to the success of the operation.
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