Preoperative 3D Planning and Intraoperative Navigation in Robot-Assisted Laparoscopic Surgery for Complex Pheochromocytoma.

Jingyang Guo, Deqiang Gu, Yang Yu, Yong Suo, Bolun Su, Tao Ma
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Abstract

Objective: To evaluate the value of preoperative 3D planning and intraoperative navigation in robot-assisted laparoscopic surgery for complex pheochromocytoma.

Study design: Observational study. Place and Duration of the Study: Department of Urology, The Affiliated Hospital of Hebei University, from July 2022 to July 2023.

Methodology: Sixty patients with complex pheochromocytoma were divided into the study group (n = 30) and the control group (n = 30) according to the treatment method. The study group was treated with robot-assisted laparoscopic surgery, with preoperative 3D printing-based planning, and intraoperative 3D navigation, and the control group underwent conventional retroperitoneal robot-assisted laparoscopic surgery. Surgical-related indicators and intraoperative and postoperative complication rates between the two groups were compared.

Results: The operation time, postoperative hospital stay, and drainage tube retention time in the study group were significantly shorter than in the control group (p <0.001), and the intraoperative blood loss in the study group was significantly less than in the control group (p <0.001). The study group exhibited a significantly lower incidence of intraoperative haemodynamic instability (HI), use of vasoactive drugs, and postoperative ICU transfer rate than the control group (p <0.05). The incidence of surgical complications in the study group was significantly lower than in the control group (p = 0.04). The non-recurrence rate in the study and control groups after 1-year follow-up was 96.7% and 90%, respectively (χ2 = 2.77, p = 0.10).

Conclusion: Robot-assisted surgery, performed through renal surface, has the advantages of less bleeding, shorter surgical time, faster recovery, fewer complications related to chromaffin cell inflammation and postoperative complications, and is safe and effective in treating complex pheochromocytoma.

Key words: 3D planning and navigation, Robot-assisted surgery, Complex pheochromocytoma.

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复杂嗜铬细胞瘤机器人辅助腹腔镜手术的术前三维规划和术中导航。
目的评估术前三维规划和术中导航在机器人辅助腹腔镜手术治疗复杂嗜铬细胞瘤中的价值:观察性研究。研究地点和时间:河北大学附属医院泌尿外科,2022年7月至2023年7月:根据治疗方法将 60 例复杂性嗜铬细胞瘤患者分为研究组(30 例)和对照组(30 例)。研究组采用机器人辅助腹腔镜手术治疗,术前进行3D打印规划,术中进行3D导航;对照组采用传统的腹膜后机器人辅助腹腔镜手术治疗。比较了两组的手术相关指标、术中和术后并发症发生率:结果:研究组的手术时间、术后住院时间和引流管留置时间明显短于对照组(P通过肾表面进行机器人辅助手术具有出血少、手术时间短、恢复快、嗜铬细胞炎症相关并发症和术后并发症少等优点,在治疗复杂性嗜铬细胞瘤方面安全有效:三维规划和导航 机器人辅助手术 复杂嗜铬细胞瘤
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