How I Do It: Robotic Choledochoscopy.

Robert Acho, Maysen Calzon, Salvatore Docimo
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引用次数: 0

Abstract

Background: As the use of the robotic platform increases among general surgeons, the amount of robotic cholecystectomies is expected to increase as well. The use of intraoperative cholangiography is valuable in assessing for choledocholithiasis. We describe our technique of performing robotic intraoperative cholangiograms with choledochoscopy. Out technique aids in efficiency since no undocking is required.

Methods: Preoperatively, the decision to perform a cholangiogram is made based on physical exam, labs, and imaging findings. The procedure begins with obtaining a critical view of safety. The robotic arms are positioned in a manner that allows all 4 robotic arms to remain docked. A ductotomy is made and the cholangiocatheter is introduced. The cholangiogram images are then interpreted and if a stone is seen in the common bile duct we will then perform a transcystic common bile duct exploration using the SpyGlass Discover digital. A complete cholangiogram is then performed. The cystic duct is secured and the gallbladder is removed from the liver bed. The patients are watched overnight and discharged on postoperative day 1.

Conclusions: A robotic approach to performing a transcystic common bile duct exploration is a safe and reproducible treatment method for choledocholithiasis. Our approach offers an advantage since no undocking is required.

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我是怎么做的机器人胆道镜检查
背景:随着普通外科医生越来越多地使用机器人平台,机器人胆囊切除术的数量预计也会增加。术中胆管造影在评估胆总管结石方面很有价值。我们介绍了利用胆道镜进行机器人术中胆管造影的技术。该技术无需解锁,因此有助于提高效率:术前,根据体格检查、实验室检查和成像结果决定是否进行胆管造影。手术首先要获得安全的关键视图。机械臂的定位方式是让所有 4 个机械臂保持对接。进行导管切开并导入胆管导管。然后解读胆管造影图像,如果发现胆总管内有结石,我们将使用 SpyGlass Discover 数字胆管造影仪进行经胆囊胆总管探查。然后进行完整的胆管造影。固定胆囊管,并从肝床移除胆囊。患者经过一夜观察,在术后第1天出院:经胆囊总胆管探查机器人方法是一种安全、可重复的胆总管结石治疗方法。我们的方法具有无需脱锁的优势。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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