在印度使用达芬奇Si系统进行良性妇科机器人手术的单中心经验:十年的真实世界数据分析

S. Rooma, B. Rupa, Nikitha K Reddy
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摘要

目的:分析近十年来使用达芬奇Si系统进行妇科良性手术的实时数据。方法:回顾性分析2012年8月至2021年7月在单个医疗中心由一名外科医生进行的达芬奇Si机器人手术的前瞻性数据。结果:在452例病例中,手术大致分为子宫肌瘤切除术(RM-204)、子宫切除术(RH-150)和子宫内膜异位症切除术(RE-80)。RH组患者平均年龄(46.12±6.77)、BMI(28.89±5.02)kg/m2高于RM和RE组。10年平均对接时间为10.59 min,平均控制台时间为96.35±47.77 min,后5年均显著低于前5年。49.9%的患者静脉镇痛时间不超过24小时,仅7.2%的患者静脉镇痛时间超过48小时。44.7%的患者住院时间少于24小时,1.1%的患者住院时间超过48小时。血红蛋白平均下降1.109±0.7531 g%, RM组明显高于对照组。RM组平均标本重量为323.8 g (200 - 1372 g), 84例出现多发性平滑肌瘤。机器人手术最常见的适应症是子宫肌瘤。结论:机器人手术用于妇科良性手术可行、安全。与腹腔镜手术相比,它具有相同的结果,优于剖腹手术。使用机器人减少开放式和重复手术的伤害矫正可以转化为减少治疗的整体经济负担。
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Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade
Objective: To analyse real time data over a decade of robotic surgery for benign Gynecological conditions using the da Vinci Si system.Methods: This is a retrospective analysis of prospectively collected data of da Vinci Si robotic surgery between August 2012 and July 2021 at single medical centre by a single surgeon.Results: Of the total 452 cases, the procedures were broadly categorised into myomectomy (RM-204), hysterectomy (RH-150), endometriosis excision (RE-80). The mean age of 46.12±6.77 and the mean BMI 28.89±5.02 kg/m2 in RH group was higher in RH group when compared to RM and RE groups. The mean docking time over 10 years was 10.59 minutes and mean console time was 96.35±47.77 minutes and both were significantly lower in the last 5 years when compared to first 5 years. 49.9% patients did not require intravenous analgesics beyond 24 hours and only 7.2% needed beyond 48 hours. 44.7% had less than 24 hours of hospital stay and 1.1% stayed beyond 48 hours. The mean hemoglobin drop was 1.109±0.7531 g%, significantly higher in RM group. The mean specimen weight in RM group was 323.8 g (200–1,372 g) and 84 cases had multiple leiomyomas. The commonest indication of robotic surgery was fibroid uterus.Conclusion: Robotic surgery for benign gynecologic surgery feasible and safe. It has equivalent outcomes when compared to laparoscopic surgery and superior when compared with laparotomy. Using robots to reduce open and repeat surgery for injury corrections could translate to reductions in the over-all economic burden of treatment.
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