机器人辅助腹腔镜盆腔廓清术的初步经验——附1例报告

发布时间：2018-03-08 17:35

本文选题：机器人手术　切入点：盆腔廓清术　出处：《中国微创外科杂志》2015年04期 　论文类型：期刊论文

【摘要】：本文报道1例54岁宫颈癌复发患者使用达芬奇机器人手术系统(da Vinci S)施行盆腔廓清术的初步经验。初次治疗行放疗外照射,随后行腹腔镜广泛全子宫切除+双侧附件切除联合盆腔淋巴结清扫术。术后6个月经阴道超声检查和盆腔CT检查均提示宫颈残端上方可见直径约2.8 cm包块,与膀胱后壁及直肠右前壁分界不清。使用达芬奇机器人手术系统共4臂进行手术,切除宫颈残端病灶及部分致密粘连的膀胱壁和病变肠管,并行耻骨联合上膀胱造瘘和结肠腹壁造瘘。手术时间480 min(自建立气腹至手术结束),出血量1200 ml。术后一般状况良好,术后第29天出院。术后病理:中分化鳞状细胞癌。术后3、6个月随访恢复好,未诉不适。我们认为达芬奇机器人系统辅助腹腔镜盆腔廓清术治疗难治性、复发性妇科肿瘤较传统手术具有操作精细灵活、创伤小、切除彻底的优势。
[Abstract]:This paper reports the primary experience of pelvic dissection with da Vinci robotic surgical system (da Vinci Vinci S) in a 54-year-old patient with recurrent cervical cancer. Then laparoscopic extensive hysterectomy combined with pelvic lymph node dissection was performed. Transvaginal ultrasonography and pelvic CT examination showed that the diameter of the mass was 2.8 cm above the cervical stump at 6 months after operation. The division between the posterior wall of bladder and the right anterior wall of rectum is not clear. Using the da Vinci robotic surgical system, we operated on four arms to remove the lesion of cervix stump and some dense adhesions of bladder wall and intestinal canal. The operation time was 480 min (from the establishment of pneumoperitoneum to the end of the operation, the amount of bleeding was 1200 ml). Postoperative pathology: moderately differentiated squamous cell carcinoma. 3, 6 months follow-up recovery, no complaints of discomfort. We believe that Leonardo da Vinci robot assisted laparoscopic pelvic dissection treatment of refractory, Recurrent gynecologic tumors have the advantages of fine and flexible operation, less trauma and complete excision.
【作者单位】：解放军总医院妇产科;解放军总医院泌尿外科;解放军总医院肿瘤外科;
【分类号】：R737.33

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